Child Dental Benefits Schedule FAQ

medicare cardThe Australian Government is expected to assist around 3.4 million children improve their dental health via a new Government funded Child Dental Benefits Schedule (CDBS). The CDBS commenced in January 2014 and continues in years to follow. The scheme is designed to assist eligible children between the ages of 2 and 17 years of age.

Are my children eligible?

A child is eligible if they are aged 2–17 years, are eligible for Medicare and receive Family Tax Benefit Part A or other relevant Australian Government payments, including:

  • Youth Allowance
  • ABSTUDY
  • Disability Support Pension
  • Parenting Payment Special Benefit
  • Carer Payment
  • Double Orphan Pension
  • Veteran’s Children Education Scheme
  • if the child is 16 or over Military Rehabilitation
  • Compensation Act Education and Training Scheme (if the child is 16 or over).

Eligible families should have received a letter to confirm eligibility from the Commonwealth Department of Human Services in January 2014.

How can I check my eligibility and balance?

You can confirm your child’s eligibility and balance amount by accessing your Medicare online account at http://my.gov.au or calling the Medicare general enquiries line on 132 011.

What kind of dental treatment can my children receive?

Benefits cover a range of dental services including examinations, x-rays, cleaning, fissure sealing, fillings, root canal treatments and extractions.

Benefits will not be available for orthodontic or cosmetic dental work and will not be paid for any dental services provided in a hospital operating theatre or oral surgery environment.

How does the $1000 cap work?

Benefits for basic dental services are capped at $1000 per child over two consecutive calendar years. If you do not use all of your $1000 benefit in the first year of eligibility, you can use it in the second year if you are still eligible.

Any remaining balance will not be carried forward at the end of the second year.

What if our family stops receiving any of the Government benefits which entitles my children to CDBS?

Your children will still be eligible for the Child Dental Benefits Schedule even if Government payments’ eligibility changes throughout the year, as you only need to be receiving benefits at some point throughout the year.

Will my Dental Practitioner be able to check if my children are eligible?

Yes, all dental practices will be able to check patient eligibility by contacting Medicare.

Will my Dental Practitioner be able to check if my children have benefits remaining?

Yes, all dental practices will be able to check patients remaining benefits balance by contacting Medicare.

Dental practices will be encouraged to check each patient’s balance at each appointment.

When does the 2 year period commence?

The 2 year period commences at the start of the calendar year, not from the first appointment date.

Can other family members use the Child Dental Benefits Schedule for their dental treatment?

The benefits can only be used by the eligible patient. Benefits cannot be shared amongst family members.

Can I use my private health insurance with Child Dental Benefits Schedule services?

No, patients with private health insurance are unable to claim benefits from both their health fund and the Child Dental Benefits Schedule for the same treatment.

What if my child is turning 2 or 18 during the year?

If your child is turning 2 or 18 at any time throughout the year, they will be eligible that year, for the full year, even when they are aged 1 or 18.

What if I become eligible for Government benefits during the year?

The Government will advise families throughout the year when newly eligible children are identified.

Can my child use the full $1000 in the first year?

Yes, patients can use their full benefits within the first year if required, but this will leave no funds available for the second year.

What happens if my child doesn't use the $1000 in the first year?

Any remaining benefits from the first year will be carried over to the second year.

What happens if my child doesn't use the $1000 within two years?

If the full $1000 is not used within two calendar years, remaining benefits cannot be used in the future.

Can my child have a dental operation performed in hospital under general anaesthetic?

Treatment performed as an inpatient at hospitals cannot be claimed from the Child Dental Benefits Schedule.

My Dentist said that he is not bulk billing patients but will bill them privately. What does this mean?

Dentists may request that patients pay in full on the day of treatment and claim back eligible benefits from Medicare.

Prior to any treatment occurring you will be informed of the treatment that will be provided on this day under the Child Dental Benefits Schedule, the likely cost of this treatment, including any out-of-pocket costs and the billing and payment arrangements for the services.

Do I need to pay a dentist after treatment?

At the time of booking you will be informed as to whether the dentist you are booking with is bulk billing for this service or will require you to pay on the day and then claim back eligible benefits from Medicare.

Benefits for some services may have restrictions under the Child Dental Benefits Schedule. In addition CDBS covers only a limited range of services.

You will need to personally meet the costs of any services not covered by the Child Dental Benefits Schedule.

 

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