Child Dental Benefits Schedule
Eligibility basics
- children aged between 2 –17 years on any one day of the calendar year
- receive, or their family, guardian or carer receives, certain government benefits such as Family Tax Benefit Part A for at least part of the calendar year
- are eligible for Medicare
Eligibility
Eligibility for the Child Dental Benefits Schedule
From January 2014, eligible families, teenagers and approved care organisations will receive a letter to confirm eligibility.
A child’s eligibility is assessed at the beginning of each year and lasts the whole calendar year. A child is eligible if they are aged 2–17 years for at least 1 day of the calendar year, are eligible for Medicare and are either part of a family receiving Family Tax Benefit Part A or one of the following Australian Government payments:
- 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 and Compensation Act Education and Training Scheme, if the child is 16 or over
Eligibility is determined each calendar year.
Benefits available under the Child Dental Benefits Schedule
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.
Process for using the Child Dental Benefits Schedule
You can confirm your child’s eligibility and balance amount by accessing your Medicare online account at my.gov.au[1] or calling the Medicare general enquiries line on 132 011.
Make an appointment with either a private or public dental provider and let them know you are eligible for the Child Dental Benefits Schedule.
At the time of the appointment, the dental provider must discuss your child’s treatment and any associated costs with you before providing the services. After this has been discussed, you will need to sign a consent form.
When the dental provider has provided the services agreed for your child, they will either bulk bill you or charge you for the services. If they charge you, you need to pay the account and claim the benefit through us.
Claiming
Claiming benefits under the Child Dental Benefits Schedule
If your dental provider bulk bills, you do not need to submit a claim.
If your dental provider does not bulk bill, you will need to pay the account and claim your benefit from us.
Submit your claim
You can submit a claim:
- electronically at the dental surgery, if your dental provider offers electronic claiming
- by downloading the Medicare claim form[2] and posting it to the Department of Human Services, GPO Box 9822 in your capital city, or placing it in the drop-box at one of our service centres
- in person at your local Medicare Service Centre
- by calling 132 011
You cannot claim a benefit under the Child Dental Benefits Schedule and from a private health insurer for the same dental service.
Check or update your details for the Child Dental Benefits Schedule
Eligibility is based on details held by Centrelink and the Department of Veterans’ Affairs.
If your circumstances change and you need to update your family details, you can do this:
- by accessing your Centrelink online account at my.gov.au[1]
- by calling the Department of Veterans’ Affairs on 133 254
If you need to update your bank account details with Medicare, you can do this online by accessing Medicare services through your myGov account.
Resources
Dental health initiatives
Find out more about the government’s dental initiatives, learn about the public dental services in your state or territory, and dental services for low income adults through the Department of Health’s website.[3]