Child Dental Benefits Schedule (CDBS) in Medicare 011-41030000

The MTDP closed on 31 December 2013. The MTDP was replaced by the CDBS on 1 January 2014.

The CDBS is a dental benefits program which covers part or the full cost of some basic dental services for eligible children and teenagers. To be eligible the child/teenager must be all the following:

• eligible for Medicare
• between 0 and 17 years old for at least one day that year, and
• receiving an eligible payment from Services Australia or the Department of Veterans' Affairs (DVA) at least once a year, or have a parent, carer or guardian receiving an eligible payment from Services Australia at least once a year

Eligibility for CDBS is dependent on all eligibility criteria being met.

The schedule of services provided by the CDBS is under the Dental Benefits Act 2008.

The customer/parent/guardian can claim up to $1,132* for each child/teenager over 2 consecutive calendar years starting from their first eligible service. The child/teenager must remain eligible each year to receive the benefit.

See Eligibility for Child Dental Benefits Schedule (CDBS) in Medicare.

*Amount is indexed annually, this is the CDBS cap amount for 2025. The Resources page has examples.

The Services Australia website has information for customers about CDBS eligibility. Customers can use quick code > QC 22426 in the website Search field to find CDBS information.

Before making an appointment, the child/teenager or their guardian/parent should:

• tell their dentist they want to use CDBS
• ask them what services are covered by CDBS and if they bulk bill

See Claims for the Child Dental Benefits Schedule (CDBS) in Medicare.

Before releasing any CDBS information, Service Officers must authenticate the child/teenager or guardian/parent enquiring.

See:

• Authenticating a Medicare customer
• Release of information

Service Officers must:

• check the child/teenager's name, DOB, and Consumer ID to make sure they are correct before releasing information.
• only release CDBS information to the:
• eligible child/teenager, or
• parent/guardian listed in the child/teenager's record

Services Australia can only release information to the guardian/parent listed on the child/teenager's CDBS record in CDMS about:

• eligibility
• remaining balance amount, and
• notification letters sent

If a customer is aged 14 or over, Service Officers cannot release information about claiming history without their consent.

Note: the guardian/parent for an eligible child/teenager can change. Centrelink and DVA systems send information about changes in care to Medicare.

If a parent/guardian says they are receiving payments for a child/teenager but are not listed as the guardian/parent for CDBS, tell them to contact Centrelink or DVA. See Child Dental Benefits Schedule (CDBS) - external and internal contacts.

Providers can use HPOS to confirm a child/teenager's:

• eligibility to claim a benefit for a particular CDBS service
• Medicare card details
• remaining balance amount

Providers who cannot access customer information through HPOS:

• can call the provider enquiries line and
• must pass a security check before CDBS information is disclosed

See Health Professional Online Services.

Notifications of eligibility for CDBS are:

• mailed out to the address recorded with Centrelink or the Department of Veterans' Affairs (DVA), or
• emailed to the customer's myGov account (if that is the customer's preferred option), and
• only issued once a child/teenager meets all criteria
• only issued for the current year

If a child/teenager is living in:

• a shared care arrangement - the guardian/parent with the highest percentage of care who is receiving the payments will get the notification of eligibility
• equal shared care arrangements - if the percentage of care is equal shared care and both guardian/parents are receiving eligible payments, both guardians/parents will receive a notification of eligibility

Lump sum Family Tax Benefit (FTB) customers get a notification of eligibility in the calendar year following the financial year to which their FTB Part A claim relates. All other customers will receive their notification of eligibility in the same calendar year as they are deemed eligible.

See Eligibility for Child Dental Benefits Schedule (CDBS) in Medicare for more details about CDBS payment eligibility.

Notification letter

Medicare sends a notification letter to an eligible child/teenager, or the guardian/parent listed on the child/teenager's CDBS record in CDMS:

• at the start of each calendar year, and
• to customers who become newly eligible throughout the year

A child/teenager who still meets eligibility criteria for the second year of CDBS will automatically get a letter of their eligibility even if the maximum benefit cap was used in the first calendar year.

Note: if a CDBS notification letter shows incorrect details or another customer's information on the letter, see Procedures for handling misdirected correspondence.

myGov notifications

Customers can manage or change their preference to receive Medicare letters electronically through myGov. Once the preference is set, all available Medicare letters including CDBS notifications will go to the customer's myGov inbox. See Using myGov accounts.

Staff can view the electronic mail preference indicator in the Medicare Online Services Entitlement screens in CDMS.

CDBS notifications sent to a myGov account are kept on file for 2 years in the customer's inbox.

If a child/teenager or guardian/parent has their Medicare online account linked to their myGov, they can check their child/teenager's eligibility and balance online. Customers can use quick code QC 51147 on the Services Australia website search field to find information about using online services to check:

• CDBS eligibility
• balance amounts

A CDBS notification may not be issued or received for several reasons. This includes if the:

• child/teenager is newly eligible, and the notification has not been issued yet
• eligible child/teenager changes care then the new carer will not receive a notification until the following year
• customer has a Returned Mail indicator on their CDBS record
• customer has not updated their Centrelink or Department of Veterans' Affairs (DVA) mailing address
• eligibility for CDBS is confirmed after the period of eligibility has passed
• information has not been received from the Centrelink system or DVA
• Centrelink or DVA information is incomplete or does not match Medicare records

Not matched and Mismatched data

This occurs when the child/teenager's details transmitted from Centrelink or DVA system:

• do not match Medicare data. This can be because of inconsistencies or missing details
• are incorrectly matched with a Medicare record

See Eligibility for Child Dental Benefits Schedule (CDBS) in Medicare for actions to take when data is not matched or mismatched.

If customer details need updating, tell the guardian/parent or child/teenager to contact the relevant agency to do this. For contact details see Child Dental Benefits Schedule (CDBS) - external and internal contacts.

The Process page has details about reviewing a customer's CDBS notification status.

Customers can ask to have the CDBS notification letter for the current calendar year reissued. An eligible child/teenager or the listed guardian/parent can do this by:

• logging into their myGov account and requesting a letter through self-service, or
• calling the Medicare general enquires line

Before reissuing any CDBS notifications, Service Officers must authenticate the child/teenager or guardian/parent enquiring.

See:

• Authenticating a Medicare customer
• Release of information

Service Officers can reissue a notification through the Notification Reissue tab on the Amend Child Dental Benefits Schedule Details screen in CDBS.

Reissued notifications:

• are a copy of the original notification sent in the current calendar year
• can only be reissued for the current calendar year
• cannot be reissued:
• for previous calendar years, or
• if the initial notification has not been sent

If returned mail is received for CDBS the return mail flag is set for the child/teenager or guardian/parent in CDBS only. CDMS may have the customer's correct details recorded because CDBS address details used for notifications are based on Centrelink or DVA data.

When the Return Mail Flag indicator is set:

• a CDBS notification cannot be issued or reissued until the returned mail indicator is removed
• Service Officers must:
• make sure the customer's address is current
• remove the return mail indicator before reissuing a CDBS notification