In 2014 the Australian Government is changing the assistance provided to families with children requiring dental treatment. The new changes replace the existing Medicare Teen Dental Plan and extend to a larger number of children.

What is the change?

Replacing the Medicare Teen Dental Plan is the Child Dental Benefits Schedule (CDBS). The new schedule commences on 1st January 2014 and will work to provide access to basic dental services for around 3.4 million children aged 2-17 years. This is an extension on the Medicare Teen Dental Plan that currently provides funding for teenagers 12-17 years of age.

What benefits do you receive if you are eligible?

Eligible children will be able to receive up to $1,000 worth of dental care over a two year calendar period. This can be used for basic general dental services including:

  • Examinations
  • X-rays
  • Cleaning
  • Fissure sealants
  • Fillings
  • Root canals
  • Extractions
  • Partial dentures

There is no restriction as to whether this treatment needs to be carried out privately or in a public setting so if eligible you will be able to acquire services from Tewantin Dental Centre for your child/ren.

Are there any restrictions on what the benefit cannot be used for?

Benefits cannot be used for orthodontic or cosmetic dental work and cannot be used for any services provided in a hospital. There will be claiming restrictions for the services you are able to claim, so please be sure to follow the correct claims process before arranging treatment.

The benefit can also not be used in conjunction with a private health insurance claim or for other siblings. You can only claim private health cover or CDBS not both.

Which providers can offer the CDBS services?

There are restrictions on who can offer CDBS services; this limits delivery to qualified practitioners with a Medicare number and who have been approved by the Department of Human Services. Please be sure to check if your dentist has undergone this approval before commencing work.

Am I eligible to claim the CDBS?

To be eligible for the CDBS your child needs to be between 2-17 years at any point in the calendar year and must receive a relevant Australian government payment, such as Family Tax Benefit Part A, at any point in the calendar year. You will receive a notification in the form of an email or letter from the Department of Human Services if your child/ren is eligible for the funding. For the majority of children this notification will be sent at the beginning of the year however reassessment will occur during the year.

How long does eligibility last?

Your child/ren will remain eligible for the full calendar year they are approved in, no matter whether they turn 2, turn 18 or are no longer receiving the relevant government payment.

How is the $1,000 over 2 calendar years tracked?

The money, where available, can be used during the full 2 calendar year period. No unused funds are rolled over and after the 2 years, if still eligible; your child will receive a second $1,000 allowance for the following 2 years. The only way this changes is if your child is deemed no longer eligible in which case funding will not be available for the year they are no longer eligible.

Example:

If your child claims $400 on May 15 2014 there is $600 remaining that can be used up until December 31st 2015. If your child turns 18 in 2014 they will not be eligible for 2015 clearing the unused amount.

If your child remains eligible in 2015 they can use the remaining $600 in 2015 and on January 1st 2016 they will receive another $1,000 allowance to take them through till 31st December 2017.

How do I make a CDBS claim?

If your dentist provides bulk-billed services you will not need to make any payment and the claim will be processed by the dentist.

If your dentist does not utilise bulk billing (private dentists) you will first need to pay for the services provided by your dentist. They will provide you with an itemised receipt which you then take to Medicare to receive your benefit payment.

The dentist will also lodge a copy of their receipt to match your claim.

Additional things to consider

There are limitations on the number of times particular treatments can be claimed. For example only one filling treatment per day is claimable and a child can only utilise inhalation (nitrous oxide) sedation twice during a twelve month time period.

Be sure to speak to your dentist about these limitations in full during your initial consultation to ensure you are aware of any additional fees that will not be covered by the benefit.

What you need to do when visiting Tewantin Dental Centre

If your child/ren is eligible for the CDBS and you have not utilised the benefit arrange an appointment with our Tewantin practice so we can assess your child’s teeth and provide treatment recommendations that meet their individual requirements. We will speak with you in regards to what is and is not covered by the CDBS benefit so you are aware of any additional expenses and how to prepare for this.

Once you receive a notification of eligibility at the start of 2014 call us on (07) 5447 1361 to arrange an appointment.