Community Health

Child Dental Benefits Schedule

Child Dental Benefits Schedule To Claim $1,052

If your child is eligible for $1,052 worth of CDBS benefits, you can claim it on the spot.  

The Child Dental Benefits Schedule, launched on 1 January 2014 is a dental benefit programme that offers children and teens aged 2-17 up to $1052 in basic dental services. The Commonwealth-funded program provides young Australian dental patients with a cap on their entitlement to basic dental services. The programme is aimed at 3.4 million kids every year.

The majority of dentists accept all CDBS claims for eligible children. You can check your eligibility by presenting the letter of eligibility (if it is available) and your Medicare card to your local children’s dentist. Then, you can make a claim on the spot. You won’t be required to pay any additional costs for basic dental services, as per the CDBS guidelines.

You can make your life easier by submitting the claim electronically. This way, you don’t need to do any paperwork. Your dentist will process all the deductions made during your appointment and then give you the remaining amount. This can be used to pay for another dental visit in the future, as long as you submit your claim within two years.

Are your children due for a routine dental check-up soon? Most dentists will help you to process claims electronically in their clinics if they are eligible for CDBS benefits.

Contact your local dentist to find out if you child is eligible for Child Dental Benefits Schedule.

Child Dental Benefits Schedule
Child Dental Benefits Schedule

How can I tell if my child qualifies?

You will have received confirmation from the Australian Government if your child is eligible for the CDBS. Each child eligible can claim up $1,052 in a 2-year period, if he/she is still eligible.

What is the eligibility criteria?

This means-tested program is only available to children who are eligible for Medicare and belong to a family receiving the Family Tax Benefit A or any of the Australian Government’s payments.

  • Parents Payment
  • Carer Payment
  • ABSTUDY
  • Youth Allowance
  • Veterans’ Children Education Scheme
  • Special Benefit
  • Disability Support Pension
  • Double Orphan Pension
  • Military Rehabilitation and Compensation Act Education and Training Scheme

For more information on CDBS entitlement criteria, please visit: http://www.humanservices.gov.au/customer/services/medicare/child-dental-benefits-schedule

Child Brushing Teeth
Child Brushing Teeth

What treatments are included in the CDBS Program?

The Child Dental Benefits Schedule covers the following basic dental services:

  • Oral Exam
  • X-ray
  • Root canal
  • Fissure sealing
  • Professional dental cleaning
  • Extraction

Please note that CDBS does NOT cover services provided by hospitals.

How can I check how much money is still in my account after a claim has been made?

To check your Medicare balance, you can call the Medicare enquiry hotline on 132 011 or log in to your Medicare account online at my.gov.au.

Can I use my private insurance as a co-pay for CDBS funds

No. You cannot use CDBS benefits if you pay for the same treatment with private funds.

If you child is eligible for CBDS services, you may claim up to $1052 in free basic dental care.

What is CDBS?

CDBS is an eligible child’s program that offers up to $1095, the benefit cap, for basic dental care over a two-year period. The program provides benefits for services such as examinations, x rays, cleanings, fissure sealants, fillings (including partial dentures), root canals, extractions, and partial dentures. In the Dental Benefits Schedule, you will find a complete list of all services, along with their item numbers, descriptions, benefit amounts, and any restrictions. The services can be delivered in either a private or public setting. Benefits are not provided for services such as orthodontics, cosmetic dentistry, or those performed in hospitals. Services Australia processes all claims under the CDBS. Check with your local Children’s Dentist for more information.

What children are eligible to receive dental care?

A child is considered eligible if: * they are eligible for Medicare; * they are aged between 0-17 at any time during the calendar year; and * they receive an Australian government payment such as Family Tax Benefit Part A at any time. Services Australia checks for new eligible children at the beginning of every calendar year. The notification will be sent by email or post to the child’s parent/guardian. The parent/guardian/patient can choose to bring this notification with them to their appointment.

How long is the eligibility period?

If a child is assessed as being eligible, they will be eligible for the entire calendar year even if they reach 18 years old. They can also stop receiving government payments. They must, however, be eligible for Medicare at the time the service is rendered. How can I determine if the patient is eligible for Medicare? You can check the eligibility of a child online via Health Professional Online Services, or call Services Australia at 132150 (call charges may be applicable).

What is the Patient’s Benefit Cap?

This maximum amount of dental benefit is available to each eligible patient for two consecutive calendars years. The benefit cap is the maximum amount of dental coverage available to an eligible patient over two consecutive calendars years. The relevant two-year period begins with the calendar year that the patient receives their first eligible dental service at their local community dentist.

If the patient receives their first dental service on 15 May, 2024, then the two-year period is the entire calendar year 2024. And if they are eligible in the following calendar year, it is the whole 2025 calendar. The patient will have the option to access a new benefit limit if they are eligible for 2025, or later. The entire patient benefit cap may be used the first year, if necessary.

The balance of the benefit cap can be used the following year, if the child remains eligible. Guide to the CDBS (Child Dental Benefits Schedule) Version 12 (January 2024) Page 6 of 47 Scenario: If the child received CDBS benefits and services worth $550 in the year 2024, they could receive additional dental benefits and services worth $545 in the following year if they were still eligible. Scenario 2 – If the child received all the services in 2024, they would have reached their $1,095 cap within the first year of relevant two-year period and would need to wait until the year 2025 to access a new cap. The two-year period for a patient who is eligible to receive the benefit cap of $1,095 begins in 2024. They will have to wait until 2025 before they can access a new benefit cap.

To find out more or make a reservation, contact your family dentist.

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