Does Medicare cover dental treatment?

What is Child Dental Benefit Schedule?

The Child Dental Benefit Schedule (CDBS) is a scheme by the Australian government run by Medicare that provides dental services benefits to eligible children. The program provides up to $1000 annually in benefits for children between two years old and seventeen years for basic dental services. The scheme is meant for families who are already receiving other benefits from the government such as Family Tax Benefit A payments. CDBS covers a wide range of dental services including dental examinations, x-rays, fillings, and root canals among other dental works. However, the program does not cover cosmetic works. These are services that are aimed at improving the aesthetic appearance of the teeth. Also, it does not cover orthodontics. This is the treatment that covers procedures meant to straighten crooked teeth such as using braces.

Children are Eligible for the Service

The Department of Human Service assesses children eligibility for this program from the start of each calendar year. A child is eligible for CDBS if they are aged between two years old and seventeen years old at any point of a calendar year. They must also be receiving a relevant payment from the Australian government such as Family Tax Benefit Part A, Disability Support Pension, Special Benefit, Carer Payment or Youth Allowance. In some cases, CDBS payments are made to guardians, parents or approved care organizations.
Once a child has been proved eligible, a notification of his or her eligibility will be sent to the parent or guardian by post or electronically. The eligibility letter may be presented to the dentist during dental appointments. The Department of Human Service continually performs routine checks throughout the year to assess children who are newly eligible. Most children who have been found to be eligible will be notifiedof their eligibility at the start of the year. Once a child has become eligible, the eligibility will remain throughout the calendar year even if they turn eighteen or stop receiving relevant payments from the government. However, the child must be eligible for Medicare at the time he or she is receiving the dental services. One can check eligibility online through the Department of Human Service website or call them directly.

How Does the Patient’s Benefit Cap of $1000 Work?

For all eligible patients, the dental benefits available is capped at $1000 over two consecutive calendar years. The two consecutive years are known as the relevant two years and the maximum amount of the dental benefits to be received is known as the benefit cap. The relevant two year period starts immediately the child receives eligibility for Medicare CDBS services. For example, if the first dental service for the patient is 15th June 2017, the relevant two year period will include the entire 2017, if the patient is eligible the following year, the entire 2018 calendar year. If still, the patient will be eligible in 2019 or later year he or she will have access to a new benefit cap.

If you do not exhaust the funds within the first year, you are allowed to use them in the second year provided the child is still eligible for the program. If there will be any remaining balance after the second year, such balance cannot be carried forward to the following year. If the child requires to receive dental services that have not been covered by Medicare, then the parent will be required to meet the cost of such services through cash or private insurance. Moreover, if the child fails to use his or her benefits, such benefits cannot be transferred to another member of the family.

Dental Services Covered by CDBS

Diagnostic and Preventive Dental Services

Diagnostic dental services are services done with the objective of identifying if there is any underlying dental problem. These services are meant to help stop the development of any dental problem and to eliminate the chance of their occurrence. Diagnostic procedures under this category include a dental examination and dental x-rays. On the other hand, preventive procedures includes teeth cleaning and scaling, and fissure sealing. Medicare dentists usually cover such services

Restorative

Just as the name suggests, restorative dental procedures are meant to correct an existing dental problem. The procedures include dental fillings, root canals among others. Dental fillingsare made out of different materials including porcelain, gold or silver. Filings are put on cavities to cover them up and restore the functionality of the tooth. The most common areas where cavities develop in the mouth is on molars and pre-molars. Recent research done by the Australian Institute of Health and Institute reported that dental cavity is the most common health problem among people in Australia. On the other hand, a root canal is performed on a tooth whose pulp is severely infected. The pulp is a very sensitive part of the tooth. It contains some living tissues that are responsible for nourishing the entire tooth. You face the risk of losing the whole tooth when it gets infected. Medicare dentists cover such services to help the patient restore their original bright smile.

Oral Surgery

Medicare dentists also cover dental procedures that involve oral surgery. Such procedures include removal of wisdom teeth. Wisdom teeth are the four molars at the back of the mouth that erupts during adolescence or early twenties. Wisdom teeth can emerge impacted thus affecting other teeth or may fail to erupt above the surface of the gums. Such wisdom teeth can become problematic and hence necessitate the dentist to extract them. Medicare insurance under CDBS covers such services.

Cosmetic Dentistry

Cosmetic dentistry involves any dental procedures that aim to improve the aesthetics of the teeth. Such procedures include teeth whitening and porcelain/composite veneers. Medicare does not cover cosmetic dentistry. Anyone who would wish to have such services done, he or she will have to pay for the services throughout of pocket cost or via the private insurance company.

Dental Implants

Dental Implants are metal posts that are surgically positioned into the jaw bone beneath the surface of the gums. Once the implants are placed, they allow the dentist to place a crown. Basically what dental implants do is to act as an artificial tooth root. As much as this procedure is necessary for restoring the functionality and aesthetic of a tooth, Medicare insurance under CDBS does not cover it.

Do All Dentist Accept CDBS Patients?

CDBS services can be provided by a private dentist or even by a dentist in a public setting. However, patients should first ask their dentist if they accept Medicare CDBS before receiving any dental services or before booking an appointment. This is because some dentists do not accept to offer their services under the program. It’s voluntary for a dentist in Australia to provide dental services under this program. The only dentists allowed to offer their services under Medicare CDBS are the ones that hold a general specialist registration with the Dental Board of Australia. They also must have a Medicare provider number.

Medicare dentists can help you verify the eligibility of your child before offering his or her services. A Medicare-participating dentist is required to discuss all the necessary dental treatment with the patient and the associated costs before offering their services. After the dentist has discussed all this information with the patient, a consent form must be signed. The dental cost will either be bulk billed, or the patient or guardian will be required to pay for the services in full before any claim is made if the service is not available at the time. If the dentist offers bulk billing services, the patient will not be required to pay any out-of-pocket cost. However, if the dentist does not offer such services, the patient will be forced to pay for the services and then submit a refund claim to Medicare.

What is Medicare Bulk Billing Services?

When you receive dental services from a Medicare dentist, he can allow you to bulk bill. Bulk billing is when your dentist accepts Medicare benefits as full payment for dental services offered. This means that you will not have to pay any out-of-pocket cost. A Medicare dentist can bulk bill a range of dental services you have received as it’s provided under Medicare Benefits Schedule. However, it is vital to note that not all dentists offer bulk billing services, so it is important to first make an inquiry before commencing your treatment. In the event that your dentist doesn’t offer bulk billing services, you as a patient will be required to file a claim to CDBS to ask for your relevant benefits. You can do this by visiting a Medicare service centre or sending an itemised receipt to the Department of Human service for the rebate.

Importance of Taking your Child to a Medicare Dentist

When it comes to children, parents are always more concern about taking care of their overall health just from the moment they are born. Unfortunately, the same efforts are not duplicated to oral health. Most parents assume taking their children for their first visit to the dentist until their permanent teeth start growing, which is a mistake. Just like it is paramount to get an early start on taking care of your child’s general health, it is equally crucial to get an early start on their oral health as well. Here are a few benefits of taking your child to a Medicare dentist:

The Routine Check-up

When a child starts visiting a dental office, it is often to get the child into the habit of getting routine dental check-ups. Routine dental check-ups enable the dentists to monitor how well a child is taking care of their oral health from one visit to another. The most common frequency of a routine check-up will be twice a year on average. Routine check-ups are also a good opportunity for the dentists to educate and review helpful oral hygiene tips with children such as proper flossing and brushing. These habits are vital to maintaining a child’s oral health. The dentist may also find the need of discussing dietary factors and strategies which are important in improving your child’s state of oral health.

It Instils Good Habits

Parents should not take it for granted that their child understands the importance of proper teeth brushing and flossing. A paediatric dentist helps educate your child on the consequences of bad oral habits and the rewards of the good ones. In addition, if your child sucks their thumb or does anything that might endanger their oral health, a Medicare dentist will be able to give suggestions on how to help them stop. Regular visits to the dentist is a good oral habit. When it is your family’s norm to go in for check-ups and cleanings twice yearly, that is something that your child may pick and carry with them into the future.

Primary Teeth are Important

When a child starts to grow some teeth, it is very important for the parents to ensure that they keep these primary teeth intact. As much as these teeth will eventually fall out, until then, the primary teeth are integral in helping your child to speak correctly and eat properly.

It Helps your Child Develop a Positive View of Dentistry

Many adults suffer from dentophobia, but you may save your child from that fate if you are keen to ensure that they receive compassionate and preventive care from an early age. This will enable them to enjoy their dental visits and keep looking forward to that clean mouth which comes after a regular dental appointment.

It Saves your Child from Pain and Suffering

Primary teeth serve as placeholders for adult teeth. If these teeth fall out too early, the ones that follow may come in crooked,and this may lead to the need for orthodontic treatment. It also saves your child from decay, which can occur as soon as teeth appear.

Factors to Consider When Choosing your Child’s Medicare Dentist

When you take your kid to the dentist, you certainly want to see the best paediatric dentist there is. After all, your child deserves the best oral health care available. Unfortunately, finding the best Medicare dentist for your child is not always that easy. Mostly, parents are uncertain on what factors to take into consideration. Usually, this results inconfusion and postponing of the dental check-ups, which should never happen as they are essential for your child’s dental development. Here are some of the factors to consider when choosing your child’s dentist:

Credentials

It is obvious that you would want someone qualified to work on your child. However, when choosing a dental clinic, go a step further and inquire if the dentist is specialised in paediatric care. Dentists who are trained in paediatric dentistry are more capable of tending to your child’s dental care. For instance, such dentists have the skills on how to deal with thumb sucking and pacifier use, offer orthodontic care and handle oral problems that stem from developmental difficulties. Most Medicare dentist has been well vetted by the Australian Dental Association and other dental bodies. Before engaging with any, first, ask to see their credentials.

Keep an Eye on the Atmosphere and Environment

During the first basic appointment, it is recommended that you sense the friendliness of the dentist. If the dentist is not kind and caring there is a high possibility that your child will not feel safe and secure. Clinics may offer IPADs with kids videos to distract the kids.

Convenience

You may find a dentist that is perfect in every way, but if their office is on the other side of the island or is only open while you’re at work, then they’re not a good choice for you. Choose a dentist whose working hours and dental office are convenient for your family.

Your Dentist Should be Kid-Friendly

This may seem obvious, but it is very important that you find a dentist that takes real joy being around children, a child has the ability of sensing when a dentist genuinely cares about them and is interested in knowing more about them.

The range of Dental Services

Paediatric dental services are different from those of the adults. As such, ensure that the dentist has child-centred services such as special preventive care, dental applications including braces and mouth guards. The dentist should also have the habit of counselling to help your child manage their oral hygiene, diagnosis and treatment of oral developmental issues among others.

Knowledgeable on All Available Procedures and Updates

Ensure that your dentist is well versed on the different procedures and updates in treating children. The dentist should be able to perform basic prophylaxis and other regular dental care and at the same time be knowledgeable and experienced when asked to perform a more complex procedure.

Reputation

Your family and friends’ recommendations can assist you in narrowing down your search for the best paediatric dentist. For even more suggestions, look for online reviews. While one review may be biased, reading several reviews may give you a fairly accurate picture of the dentist.

See How the Dentist Reacts to More Troublesome Children

Some children like to act out and make a scene during their dental visits. Mostly, this happens when the fear and anxiety gets too overwhelming. In such a case, it is important that the dentist finds a way of calming the child down. If the dentist seems like he is losing his patience or is too aggressive, you are better off finding another dentist.

Bottom Line

As parents, you spend much of your time worrying about the health and well-being of your children. However, very few of you worry about their oral health. Some, especially from low income earning families, say that dental services are too costly to afford. With the introduction of the new Medicare service under the Australian government known as Child Dental Benefits Schedule (CDBS), this doesn’t have to be this way. The program has made dental services to be affordable for all families. Medicare under Child Dental Benefit Scheme (CDBS) is a program that allows children between the age of two all the way to seventeen to receive relevant dental services and visit the dentist on a regular basis.

Taking your child to see the dentist early enough develops good oral hygiene measures to the child and helps to catch any oral problem early enough. If you notice any issues with your child’s oral health, be sure to discuss it with your dentist during your next visit. This will help the child keep their natural teeth even during old age.