Below is information from the Australian Govt. website outlining the key facts relating to the Child Dental Benefits Schedule. Source: https://www.servicesaustralia.gov.au/individuals/services/medicare/child-dental-benefits-schedule
The Child Dental Benefits Schedule covers part or the full cost of some dental services for children if you get certain payments from the Australian Govt.
To get this your child must be:
- 2 to 17 years old for at least 1 day that year
- eligible for Medicare
- getting a payment from us at least once a year, or have a parent getting a payment from us at least once a year.
Read the full conditions under who can get it below.
Who can get it?
You don’t need to apply or register for CDBS. If your child is eligible we will usually send you a letter.
Your child can get CDBS when:
- they are eligible for Medicare
- they are between 2 and 17 years old for at least 1 day that year
- you or they get an eligible payment at least once that year.
You can be either the child’s:
- parent or guardian
- approved care organisation.
- If you’re a teenager and have a partner
You may be able to get CDBS in a calendar year when:
- you’re 17 years old, or younger for at least 1 day that year
- your partner gets an eligible payment from the Government.
If you are still unsure if your child is eligible, please call us and we can check your eligibility with you.
We cover up to $1,013 over 2 calendar years for basic dental services under CDBS. The services we will cover include:
- fissure sealing
- root canals
There are some restrictions for basic dental services. You should check with your dentist if there are any item or time restrictions before starting your service.
These services don’t count towards the threshold of the:
The services we won’t cover are:
- orthodontic dental work
- cosmetic dental work
- any dental services in a hospital.
The 2 year period
You can claim up to $1,013 for each child over 2 consecutive calendar years.
The 2 year period starts at the beginning of the calendar year in which your child both:
- becomes eligible
- gets their first dental service.
You can use the full amount of $1,013 in the first year. This will leave no funds for the second year. If you don’t use the full $1,013 in the first year, you can use it in the second year. You can only use it in the second year if your child remains eligible.
If you don’t use the full amount within the 2 calendar years, you can’t use the remaining funds. You’ll have to wait for a new 2 year cover period to start.
You also won’t be able to use any remaining funds once your child is no longer eligible.
How to use
You can get child dental benefits for services at most dentists. Don’t forget you can only claim benefits for:
Before going to the dentist
When you book an appointment, say you want to use CDBS. Check how close you are to the $1,013 limit. This will tell you what benefit amount you can get. If you’re not sure how much is left you can either:
Your dentist should also check your child’s available benefit amount at the appointment.
At the dentist
At the appointment, discuss:
- what each service will cost
- if CDBS will cover the services.
You’ll get a consent form. This says you agree to the services and what they cost. Check these, then sign if you agree.
Some dentists give you a bill to pay on the day of the service. You can then claim a benefit from us. You can often do this at the dentist straight after you pay.
If the dentist bulk bills you don’t need to pay or claim.
How to claim
You can’t claim from us and a private health insurer for the same dental service.
You can claim your benefit either:
- at the dentist when you pay
- directly from us if your dentist doesn’t bulk bill.
Not all dentists bulk bill. You should check if yours does when you make an appointment. To find a dentist who bulk bills, use the find a health service tool on the healthdirect website.
If your dentist doesn’t claim on your behalf, you can claim by using any of:
When we’ve processed your claim, we’ll pay the benefit into your bank account.