Medicare Child Dental Benefits Scheme

The Government provides assistance for 2 – 17 year olds through the new Child Dental Benefit Schedule which commenced on 1st January 2014. This replaces the Medicare Teen Dental plan.

To see if your family is eligible please visit Child Dental Benefits Scheme. This is great for parents who are planning to invest for their child’s dental care.

What Is the Child Dental Benefits Schedule (CDBS)?

The Child Dental Benefits Schedule is a Medicare funded program that helps eligible families access essential dental services for children aged 2 to 17 years.

To qualify, the child must:

• Be eligible for Medicare
• Receive or be part of a family receiving certain Government payments
• Meet the eligibility requirements for at least one day during the calendar year

Eligibility is assessed by Services Australia, and families are notified directly if their child qualifies.

In 2014, benefits for basic dental services are capped at $1,000 per child over 2 consecutive calendar years. If you do not use all of your $1,000 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.

Benefits will cover a range of services including examinations, x-rays, cleaning, fissure sealing, fillings, root canals and extractions. Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in a hospital. Child Dental Benefits Schedule services will not count towards the Medicare Safety Net or the Extended Medicare Safety Net thresholds.

What Dental Services Are Covered Under the CDBS?

The Child Dental Benefits Schedule covers a broad range of essential dental services designed to support the oral health of eligible children. Understanding exactly what is and is not included can help you plan your child’s dental care and make the most of the benefit available.

Covered Services

Examinations and Diagnosis

Regular dental examinations are covered under the scheme, including comprehensive check-ups to assess the overall health of your child’s teeth, gums, and mouth. X-rays to support diagnosis are also included, allowing your dentist to identify issues that may not be visible during a standard examination, such as decay between teeth or developing problems with adult teeth.

Preventive Treatments

Preventive care is a key focus of the CDBS. Covered preventive services include:

• Professional cleaning to remove plaque and tartar buildup
• Fissure sealing, which involves applying a protective coating to the deep grooves of the back teeth to prevent cavities from forming
• Fluoride treatments to strengthen tooth enamel and reduce the risk of decay

These preventive services are particularly valuable for children, as establishing good oral health habits and protecting teeth early can help avoid more costly and invasive treatments later on.

Restorative Treatments

If your child has already developed decay or damage, the CDBS also covers a range of restorative treatments to repair and protect affected teeth, including:

• Tooth-coloured or amalgam fillings to restore teeth affected by cavities
• Root canal treatment for teeth where the pulp has been affected by infection or decay
• Extractions where a tooth cannot be saved or is causing problems with the development of surrounding teeth

What Is Not Covered

It is equally important to understand the limitations of the scheme so there are no surprises when it comes to billing. The CDBS does not cover:

• Orthodontic treatment, including braces or clear aligners
• Cosmetic dental procedures
• Any dental services provided in a hospital setting
• Services that exceed the two-consecutive-year benefit cap of $1,000 per child

A Note on Benefit Limits

The $1,000 benefit cap applies across two consecutive calendar years. This means it is worth planning your child’s dental care across both years to make the most of the available funds. For example, scheduling a check-up and clean in the first year and any required restorative work in the second year can help spread the benefit effectively. Any unused balance at the end of the second year cannot be carried forward, so it is important not to leave it unused.

If you are unsure what services your child may need or how best to use the available benefit, our team is happy to help you plan. Contact us to discuss your child’s dental needs and we will work with you to make the most of the CDBS entitlement.

Please note:

1. Eligibility will need to be confirmed before commencement of dental care.
2. Please inform the receptionist of your intention to utilise this scheme when you book your appointment. Our receptionist will require your Medicare number and the child’s member number at this time. We will need confirm your child’s eligibility before the day of the initial appointment and on each appointment day thereafter if further treatment is required.
3. Without this confirmation treatment cannot be provided under this scheme. Benefit balances available are not transferable between family members. Not all treatment options are covered by the scheme. In particular Orthodontic and Cosmetic treatments are not covered by the scheme.

Frequently Asked Questions

Who is eligible for the CDBS? Children aged 2 to 17 who are eligible for Medicare and whose family receives certain Government payments may qualify. Eligibility is assessed by Services Australia, who will notify families directly.

How much is the benefit? Eligible children receive up to $1,000 in benefits, spread across two consecutive calendar years. Unused funds from the first year carry over to the second, but any remaining balance at the end of the second year is forfeited.

Can the benefit be shared between siblings? No. Each eligible child has their own separate $1,000 entitlement. Balances cannot be transferred or shared between family members.

What services are covered? The scheme covers examinations, x-rays, professional cleaning, fissure sealing, fluoride treatments, fillings, root canal treatment, and extractions.

What is not covered? Orthodontic treatments (such as braces or aligners), cosmetic dental procedures, and any services provided in a hospital are not covered. CDBS services also do not count towards the Medicare Safety Net thresholds.

What do I need when booking? Let our receptionist know you plan to use the CDBS when booking. You’ll need to provide your Medicare card number and the child’s member number. Eligibility must be confirmed before the first appointment and before each subsequent visit.

How can I make the most of the $1,000 benefit? Consider spreading your child’s care across both eligible years — for example, a check-up and clean in year one, and any restorative work in year two. Our team can help you plan ahead so no benefit goes to waste.