Child Dental Benefits Schedule For Healthy Little Smiles

To check your child’s eligibility and balance for the Child Dental Benefits Schedule (CDBS), you can follow these steps:

1. Log in to your MyGov account:
   Access your linked Medicare account, where initial eligibility and balance information are displayed.
2. Check eligibility details:
   Eligibility is based on the child being between the ages of zero and 17 years old. Also, the family should be receiving relevant government benefits, such as Family Tax Benefit Part A.
3. Review balance:
   The system will show the balance of the $1,095 cap available for each child over two calendar years.
4. Contact Medicare for assistance:
   If you need more detailed information or have issues accessing the balance, you can directly contact Medicare by phone or visit a service centre.

By regularly checking these details, you can plan your child’s dental treatments more effectively, making the most out of the benefits provided. It’s important to stay informed about the remaining balance and eligibility status to avoid unexpected costs.

Under CDBS, your children can access a variety of basic dental treatments to maintain their oral health. Here’s a list of treatments covered:

• Examinations:
  Regular dental check-ups to assess oral health and plan necessary treatments.
• X-rays:
  Diagnostic imaging to help identify dental issues that may not be visible during a regular exam.
• Cleaning:
  Professional teeth cleaning is needed to remove plaque and tartar build-up, which helps prevent tooth decay and gum disease.
• Fissure sealing:
  Application of a protective dental sealant to the grooves of children’s back teeth to prevent decay.
• Fillings:
  Restoration of damaged or decayed teeth using dental fillings to restore function and aesthetics.
• Root canal treatment:
  Treatment for a tooth with an infected pulp, aimed at preserving it and avoiding extraction.
• Extractions:
  Removal of one or more teeth due to decay, infection or injury.

These services are aimed at preventing and addressing common dental problems, allowing your child to maintain good oral health. It’s important to use these benefits proactively, as regular dental care can prevent more complex issues later on.

The two-year period required for CDBS benefits is calculated based on the calendar year, not from the date of the first claim. It starts on January 1st and ends on December 31st of the following year, covering a full two years. During this period, eligible children can access up to $1,095 for dental services. If the full $1,095 is not used in the first year, the remaining balance can be used in the second year, provided the child remains eligible.

Once the CDBS benefit cap of $1,095 is reached within the two-year period, no further claims can be made until the next eligibility period begins. This means that any additional dental treatments required after reaching the cap must be funded by other means. Parents or guardians will need to cover the costs of further treatments out-of-pocket or explore alternative funding options, such as private health funds, if available. It’s crucial to manage and plan the use of CDBS benefits wisely to cover as much necessary dental work as possible within the cap.

Yes, there may be a gap payment for CDBS services, depending on the dental provider’s fees. If the dentist’s charges exceed the CDBS benefit limits for the provided services, the excess amount will be the responsibility of the parent or guardian. It’s important to discuss fees with your dentist before treatment to understand any potential out-of-pocket costs. Some dentists may offer services within the CDBS cap, which means no additional payment is needed from you.

Yes, preparing for your child’s CDBS appointment requires a few important steps to make everything go smoothly. Here’s a list of things you should do before the appointment:

1. Check eligibility:
   Confirm that your child is still eligible for the CDBS. This involves checking that the child is between zero and 17 years old and that you still receive a qualifying government benefit. You can check this via your MyGov account linked to Medicare.
2. Review the available benefits:
   Understand how much of the $1,095 biennial cap has been used and what amount remains. This will help in planning the necessary treatments within the cap limits.
3. Contact the dental clinic:
   Before making an appointment, confirm that the clinic accepts CDBS and discuss any necessary pre-appointment requirements they might have.
4. Schedule the appointment:
   Select a suitable appointment time that falls within the remaining coverage available under CDBS, if necessary.
5. Prepare documentation:
   Gather all necessary documents, such as your Medicare card, identification, and any relevant previous dental records.
6. Discuss treatment needs:
   If your child has been experiencing specific dental issues, it may be useful to jot these down to discuss with the dentist during the visit.
7. Confirm treatment costs and cover:
   Check if the planned treatments are covered under CDBS and verify any potential out-of-pocket costs with the clinic beforehand.
8. Prepare your child:
   Explain to your child what the visit might entail, particularly if it’s their first dental visit or if they have dental anxiety. This is to help make the experience as comfortable as possible.

These steps will help you handle all logistical and administrative aspects before your visit, allowing you to focus during the appointment. By managing these details beforehand, you can help create a smooth and efficient experience for both your child and the dental team.

Private health funds can be used to pay for additional treatments not covered by the CDBS. This allows for more comprehensive dental care through:

• Distinct claims:
  Treatments eligible under the CDBS must be exclusively claimed through this program. Meanwhile, treatments not included in the CDBS can be covered by your private health fund.
• Enhanced treatment options:
  Using your private health fund for treatments beyond the CDBS scope can expand the range of dental care available to your child.

This strategic use of both funding sources broadens your child’s dental care options without overlapping claims. This is for effectively managing dental health expenses so your child receives all necessary treatments.