Centrelink enquiries for Child Dental Benefits Schedule (CDBS) 101-03030000

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Description

1

Effect of FTB Lump Sum claim year on eligibility for CDBS

A customer can lodge an FTB lump sum claim for the previous financial year up to 12 months after the end of the financial year. In special circumstances, Centrelink can accept a FTB lump sum claim up to 2 years after the financial year being claimed. Eligibility for Child Dental Benefits Schedule is for the calendar year immediately following the financial year being claimed for in the lump sum claim. This regardless of whether the FTB lump sum claim is lodged within 12 months after the end of the financial year being claimed for, or lodged late because of special circumstances.

Eligibility for the Child Dental Benefits Schedule in the 2023 calendar year is determined based on the outcome of a FTB lump sum claim lodged in respect of the 2021-2022 financial year.

2

FTB customer receiving instalments and changes payment choice to lump sum

For the 2020-21 financial year, a customer received FTB by instalment payments. The customer is eligible for CDBS for the 2021 calendar year.

The customer’s instalment entitlements were cancelled on 1 July 2021.

For the 2021-22 financial year, the customer lodges an FTB lump sum claim.

FTB is assessed and paid by financial year, if a customer gets an FTB Lump sum, they do not get CDBS until the following 1 January. For 2021-22 financial year lump sum claim, the customer will be eligible for CDBS for the 2023 calendar year

3

Customer lodges FTB lump sum claim prior to end of Child Dental Benefits Schedule calendar year

Where a customer lodges 2021-22 FTB Lump Sum Claim before 31 December 2023, the eligibility for Child Dental Benefits Schedule for 2022 will be determined on their entitlement for FTB Part A in 2021-22. Their details will be sent to Medicare who will determine if Medicare eligibility criteria are met.

4

Customer lodges FTB lump sum claim after end of Child Dental Benefits Schedule calendar year

Where a customer lodges 2020-2021 FTB Lump Sum Claim after 31 December 2022, they may be eligible in 2022 but Medicare will not mail a notification of eligibility.

Customers can check eligibility and their remaining CDBS benefit cap amount for the child/teenager by accessing Medicare services through myGov, Express Plus Medicare app or contacting the CDBS team.

Eligibility for the Child Dental Benefits Schedule in the 2022 calendar year is determined based on the outcome of a FTB lump sum claim lodged in respect of the 2020-21 financial year.

5

Customer receiving Parenting Payment (PP)

From 20 September 2023, a child must be aged under six to be a PP child for Parenting Payment Partnered (PPP) or aged under 14 to be a PP child for Parenting Payment Single (PPS).

If a customer is receiving Parenting Payment, they or their children may be eligible for CDBS. In most cases, the customer would also be receiving Family Tax Benefit Part A for the children and this would be the qualifying payment for CDBS.

A customer receiving Parenting Payment Partnered (PPP) only queries why her two youngest children are eligible for CDBS but not her oldest child. First check the child’s age, if they are under six, check a PPP line has been coded on the Child Override/Claim (CHOC) screen to assess them as a PP child. If they are deemed to be a PP child, a Y will be listed under PPP on the Child Selection (CHS) screen.

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Frequently asked questions

1

When did the CDBS commence?

1 January 2014 for the 2014 calendar year. CDBS replaced the Medicare Teen Dental Plan, which started 1 July 2008 for the 2008 calendar year.

2

How do customers know they are eligible for CDBS?

Medicare will mail a notification to eligible customers at the start of each calendar year and to those that become newly eligible throughout the year. Examples of where a customer may not get a notification are:

• An eligible child/teenager changes care. The new carer will not receive a notification until the next calendar year
• An eligible child/teenager stops attracting FTB and starts to receive a payment in their own right. The child/teenager will not receive a notification until the next calendar year

Customers do not need to take their notification to the appointment or to be able to claim for a dental service. Customers can check eligibility and their remaining CDBS benefit cap amount for the child/teenager by accessing Medicare services through myGov, the Express Plus Medicare App or contact the CDBS team.

Dentists can also check eligibility and remaining benefit cap amount for the child/teenager online via the Services Australia website, Medicare for health professionals.

3

Eligibility period and FTB lump sum claims

Eligibility for Child Dental Benefits Schedule is for the calendar year immediately following the financial year being claimed for in the FTB lump sum claim. This is regardless of whether the customers lodges the lump sum claim prior to or after the end of the Child Dental Benefits Schedule calendar year.

For example, a customer lodges an FTB lump sum claim on 15 January 2023 for the 2021-2022 financial year and is granted. The child/teenager is deemed eligible for the 2023 calendar year. The child/teenager went to the dentist in 2023. The customer can claim for this service.

4

How the benefit cap works

A patient’s entire benefit cap can be used in the first year if needed. If the entire benefit cap is not used in the first year, the balance can be used in the following year if the child is still eligible.

Scenario 1

If a child receives Child Dental Benefits Schedule services and benefits to the value of $550 in 2022, then in 2023 if they are still eligible for the Child Dental Benefits Schedule they can receive more dental services and benefits to the value of $502.

Scenario 2

If the child receives all of the services in 2021 they would reach their $1,052 benefit cap in first year of the relevant 2 year period (see below), and would have to wait until 2023 before they can access a new benefit cap.

• 2022 – first year services are provided
• 2023 – second year where the patient can access any remaining balance if they are still eligible
• 2022-2023 – benefit cap of $1,013 over 2 consecutive calendar years
• 2024 – the patient will have access to a new benefit cap starting from this year, if they are eligible
• any balance remaining at the end of the relevant 2 year period cannot be used to fund services provided outside that period
• a patient’s benefit cap can only be used for eligible services provided to that patient: family members cannot share their entitlements