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Whether you have private health insurance or not, your child should be covered

All parents and all dental health practitioners want all children to get at least basic dental care and treatment.

The Federal Government has supported that goal for the past seven years through the Child Dental Benefits Schedule (CDBS).

The CDBS essentially covers all the costs of most dental services a child might need, capped at $1013 per child over a two-year period (this went up from the previous cap of $1000 on January 1, 2021).

Who is eligible?

Your child may be eligible if he or she is aged between 2 and 17 and eligible for Medicare.

You or your child also needs to be receiving Family Tax Benefit Part A or another relevant Australian government payment (further details are here on the Services Australia website).

What do you get?

Eligible children pay nothing and there are no out-of-pocket costs for basic dental services (orthodontics and cosmetic dental work are not covered) as treatment is bulk billed via Medicare.

The 24-month period during which all costs are added up until you reach the $1013 cap is two calendar years, so from January 1st this year until December 31st next year (2022), and also January 1, 2022, through December 31, 2023 (that is, the two-year periods keep rolling).

There is no wait list – we will book the next available appointment here at our dental clinic in Box Hill.

What dental services are available?

The following are the dental services considered ‘basic’ for the purposes of the CDBS:

  1. Check-ups
  2. Fissure sealants
  3. Cleaning
  4. Fillings
  5. X-rays
  6. Extractions
  7. Root canals

We accept all private health schemes, too

As well as bulk billing for CDBS-eligible services, Middleborough Dental Care accepts coverage by all health funds, and we process rebates on-the-spot via HICAPS rebate services.

We also offer gap-free check-ups and cleaning for children under 18 with private health insurance.

If you have private health insurance, the chances are that you’re covered for at least some standard dental procedures as part of your plan. Most of us who have private health insurance have opted for a level of ‘extras’ cover, which can also help to cover the cost of less-common procedures.

If you are a member of Australia’s largest not-for-profit health fund, HCF, we take part in their More for Teeth program, which offers 100% back on a range of diagnostic and preventative services, including x-rays and mouthguards (subject to annual limits).

What are annual limits?

An annual limit is the maximum amount of money you can claim for a particular service within a year. With some insurers, the annual limit increases the longer you stay with that provider.

Most insurers work on a calendar year, so if that applies to your policy, the limit has just reset.

The sorts of treatments that are fully or partially covered vary from policy to policy, and here in Australia, it can be a bit more complex given that we don’t have the option of specific dental insurance.

What’s covered by private health funds

In general, your policy will specify either major or dental coverage, or possibly both, each with a different annual limit.

General dental covers preventative treatment services, like oral exams, scale and cleans, and simple fillings.

Major dental covers surgery (complex fillings, extractions, root canals, etc) and emergency treatment.

Time to review your cover?

The start of a new year might also be a good time to review your private health insurance plan to ensure it’s still the best level of cover for you and your family, particularly as you and your children get older.

And it’s worth focusing on the dental cover portion, because dental is clearly the main service claimed on private health insurance, with 52.5% of payments being for dental services (optical at 17.2% is next).

We look forward to seeing you soon

We want to see you and your children regularly, as that’s the best way to ensure we’re looking after your oral health as well as possible.

The whole MDC team is dedicated to being the best family dentist in Box Hill – and, if you’re already a patient, we hope you agree!

Whether you’ve been to see us before or not, you can contact us with any questions or to make an appointment, or you can use our online booking form.