Child Dental Benefits Schedule (CDBS)

The Child Dental Benefits Schedule is a Medicare programme that helps cover the cost of basic dental treatment for eligible children. Victorian Dental Group treats children under the CDBS, and this page explains how it works in practice.

Eligible children are aged 0 to 17. If your child qualifies, you should receive a letter from Medicare telling you so.

Who is eligible

Eligibility is set by Medicare and administered by Centrelink. It is not determined by us, and we cannot make a child eligible.

Broadly, a child aged 0 to 17 qualifies for a given calendar year if they are eligible for Medicare and the family receives a qualifying payment such as Family Tax Benefit Part A, or the child themselves receives a relevant payment. Eligibility is assessed each calendar year, so a child who qualified last year may not this year, and the reverse.

Not all families are eligible. The criteria and the qualifying payments do change, so confirm your position directly with Services Australia rather than relying on a summary anywhere — including this one.

If you are unsure, ask us to check your child's balance. With your consent we can look it up, and it takes a moment.

How much is covered

Eligible children can receive up to $1,158 in benefits over two consecutive calendar years.

The cap is indexed and changes over time, so confirm the current figure with Medicare. Any unused balance at the end of the two-year period does not carry over.

The benefit is per child, not per family.

How the two-year period actually works

This is the part that causes the most confusion.

The practical consequence: an unused balance is not a saving. If your child is eligible and has not been seen, a check-up is worth booking rather than deferring.

What is covered

The schedule covers basic dental services:

What is not covered

There are limits on individual items as well as the overall cap. Medicare can tell you what applies to your child's balance, and we will flag it if a proposed treatment falls outside what the schedule covers.

Common misunderstandings

What people think What is actually the case
"It resets every year" The cap runs over two consecutive calendar years
"Every child gets it" Eligibility depends on family payments and is assessed annually
"It covers braces" Orthodontics is excluded entirely
"The dentist bulk bills it" Here, you pay on the day and claim the benefit back
"Unused balance rolls over" It does not. It lapses at the end of the period
"It is a Victorian scheme" It is federal, through Medicare, and applies nationally
"It covers treatment in hospital" It does not — hospital and general anaesthetic dental sit outside it

How it works at this practice

  1. Tell us when you book that your child may be eligible, and bring your Medicare card
  2. We can check the remaining balance with your consent
  3. Your child is examined and you receive a treatment plan, with costs, before anything proceeds
  4. You pay the account in full on the day of the appointment
  5. We give you an itemised statement with the item numbers on it
  6. You submit the claim to Medicare and are reimbursed

Depending on your child's remaining entitlement and the treatment provided, there may be a small out-of-pocket amount. That is determined by Medicare, not by us, and we will tell you in advance where we expect one.

How to submit your claim

Once you have the statement, you can claim through any of:

Keep the statement until the reimbursement has come through.

Using it alongside private health cover

Plenty of families have both. The order to use them in:

  1. CDBS first, where the child is eligible and the item is covered by the schedule
  2. Private extras cover for anything the schedule does not cover, or once the balance is used
  3. Whatever is left is the gap you pay

You cannot claim the same item from both. Where a treatment falls outside the schedule — orthodontics being the common one — extras cover is the relevant option, subject to its own limits and waiting periods. See private health insurance.

Making the benefit go further

A few things worth knowing, since the balance is finite:

What a child's appointment involves

Age What the visit is mostly about
Around 1, or first tooth Familiarity, a look in the mouth, advice on brushing and bottles
2–5 Short examinations, fluoride, counting teeth, building the habit
6–8 First permanent molars arriving — sealants, and watching eruption
9–12 The rest of the adult teeth, space and alignment, whether an orthodontic opinion is worth seeking
13–17 Adult-pattern care: decay risk, gum health, grinding, mouthguards, wisdom teeth

A parent or guardian needs to attend to give consent for a child's treatment. Mornings usually go better than late afternoons.

Other options for children in Victoria

Worth knowing about, because the CDBS is not the only support available.

Smile Squad is the Victorian government's free school dental programme, offering dental care to students at Victorian government schools through visiting vans and clinics. Eligibility and scheduling are set by the programme and your child's school, not by us.

Public dental services are available to eligible children — generally those in families holding a concession card — through community dental clinics and the Royal Dental Hospital of Melbourne, 720 Swanston Street, Carlton. Waiting times apply for general care; emergency care is prioritised.

Using one of these does not prevent you from attending here, and records can be transferred either way. See transfer of records.

If your child is not eligible

They are treated the same way here, and the same written quote process applies. Your options are on the payment options page — private health cover claimed on the spot through HICAPS, paying on the day, Afterpay, Zip, or staging treatment by clinical priority.

Eligible concession card holders can also access the Victorian public dental system, which is separate from this practice and has its own eligibility rules and waiting times.

Questions we are asked

How do I know if my child is eligible? Medicare writes to eligible families. If you have not had a letter and think you should have, contact Services Australia, or ask us to check the balance.

Does the benefit reset every year? It is assessed over two consecutive calendar years rather than annually. Eligibility itself, however, is assessed each calendar year.

Can I use it at more than one practice? Yes. The balance follows the child, not the practice.

Do you bulk bill under the CDBS? No. The account is paid in full on the day and you claim the benefit back from Medicare.

Can it be used for braces? No. Orthodontic treatment is outside the schedule.

What if we run out of balance mid-treatment? We will know before that happens and will tell you, so you are not surprised at reception. Remaining treatment can usually be staged.

My child turns 18 soon — what happens? The benefit ends at 18. If there is balance remaining and treatment outstanding, it is worth bringing the appointment forward.

Can grandparents or another carer bring the child? Yes, provided whoever attends can give consent for treatment. Tell reception in advance so nothing is held up on the day.

Does using the CDBS affect my private health cover limits? No. They are separate; the CDBS is a Medicare benefit and your extras limit is your fund's.

Is a check-up worth it if my child has no problems? That is precisely when it is worth most. Sealants, fluoride and early advice are what stop the balance being needed for fillings later.

Book your child's appointment

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145

Phone (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · closed weekends and public holidays

Book online at any hour, or read more about family and children's dentistry and check-up and hygiene fees.

This page is general information about a Medicare programme. Eligibility, benefit amounts, covered services and restrictions are set by Medicare and administered by Services Australia, and they change from time to time — confirm your own position with them. This page does not replace advice from a registered dental practitioner about your child's circumstances. Please see our Disclaimer.

What is the Child Dental Benefits Schedule?

A Commonwealth program, administered through Medicare, that pays benefits towards basic dental care for eligible children. It is a government scheme rather than a practice offer — Victorian Dental Group treats children under it, but eligibility and the benefit amount are set and assessed by Services Australia, not by the practice.

Which children are eligible?

Children aged 0 to 17 at some point in the calendar year, who are eligible for Medicare, and whose family receives an eligible payment — most commonly Family Tax Benefit Part A, but several other payments also qualify. The child must be eligible for Medicare on the day of treatment. Eligibility is assessed each calendar year; being assessed as eligible later in the year backdates to 1 January of that year.

How much is the benefit?

A capped total per child across two consecutive calendar years — $1,158 at the time of writing, indexed annually. It can be used entirely in one year or spread across the two. Any balance not used by the end of the two-year period is lost; it does not carry forward. Confirm the current cap and your remaining balance with Medicare before planning treatment.

How do I check my child's eligibility and balance?

Through myGov, under Medicare, then Child Dental Benefits Schedule, or by phoning Medicare on 132 011. Families are usually notified by letter, but do not rely on the letter alone — check the balance directly, particularly if your child has been treated elsewhere during the same two-year period, because the cap is shared across all providers.

What treatment does the CDBS cover?

Basic general dental care: examinations, X-rays, cleaning, fluoride application, fissure sealants, fillings, root canal treatment and extractions.

What does the CDBS not cover?

Orthodontic treatment of any kind, cosmetic dental work, and any service provided in a hospital. These are excluded outright, regardless of remaining balance. If your child needs braces or a plate, the CDBS will not contribute to it.

Will there be anything to pay?

That depends on the practice's billing arrangement and on whether the treatment needed falls within the covered items and the remaining balance. Before treatment starts you are told which items are claimable, what the benefit covers, and what if anything is payable, so there is no surprise afterwards. If the balance runs out partway through a plan, you are told before continuing.

Is there any Medicare dental cover for adults?

Generally no. Medicare does not fund routine dental care for adults. The limited exceptions are certain oral surgery performed in hospital and some services under a Chronic Disease Management plan through your GP, which are narrow and specific. Adults holding a concession or health care card can access public dental care through Dental Health Services Victoria and community dental clinics, where waiting lists apply. Otherwise adult dental costs are met privately or through private health extras cover.

Who do I ask about using the CDBS here?

Victorian Dental Group, 291 Wattletree Road, Malvern East VIC 3145. Phone (03) 9088 5808 or email info@victoriandentalgroup.com.au, Monday to Friday 8:00am to 5:00pm. Bring your child's Medicare card. Questions about eligibility itself are answered by Medicare on 132 011.

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