For a child whose two-year benefit period starts in 2026, Medicare will contribute up to $1,158 towards basic dental care through the Child Dental Benefits Schedule (CDBS). That money can pay for check-ups, cleans, X-rays, fillings and more, and at practices that bulk bill it the family pays nothing for covered items. Plenty of eligible families never use it, usually because they did not know their child qualified.
Written by Dr James Tran, dentist at Lumi Dental.
Three conditions decide eligibility
Medicare checks eligibility each calendar year. A child generally qualifies when all of the following apply at some point in that year:
- the child is aged 0 to 17
- the child is eligible for Medicare
- the child, or their parent or guardian, receives a qualifying government payment, such as Family Tax Benefit Part A (several other payments also count)
Services Australia usually sends a letter to families when a child becomes eligible, but letters get missed. If you receive Family Tax Benefit Part A, it is worth checking even if nothing arrived in the mail.
How the two-year cap works
The cap is not paid out as cash. It is a balance that Medicare draws down each time an eligible service is claimed. The two-year window starts on 1 January of the year in which your child is eligible and has their first CDBS-funded visit, and it runs to 31 December of the following year.
A few details catch families out:
- The cap is indexed each year, and the amount your child has depends on the year the window began. A window that opened in 2025 keeps the 2025 cap of $1,132 for both years.
- Unspent money can be used in the second year only if your child is still eligible that year.
- Anything left at the end of the two years lapses. A new window can open the next time your child is eligible and has a CDBS-funded service.
What it pays for, and what it does not
The scheme is designed for everyday dental care. According to the Australian Government's guide to the scheme, covered services include examinations, X-rays, cleaning, fissure sealants, fillings, root canal treatment and extractions. Each item has its own limits on how often it can be claimed, so your dentist will check before going ahead.
Orthodontics (braces and clear aligners), cosmetic treatment and any dental care provided in a hospital are not covered. If your child needs braces later, that is a separate private cost, though health fund extras cover may help.
Bulk billed or a gap: ask before the visit
Practices choose how they bill CDBS services. When a practice bulk bills, it claims directly from Medicare and accepts the Medicare benefit as full payment for each covered item, so there is no out-of-pocket cost for those items while the balance lasts. Other practices charge their normal fee and you claim the benefit back, which can leave a gap.
Either way, before any CDBS treatment the dentist must explain the proposed care and its cost, and a parent or guardian signs a consent form. At Lumi Dental, eligible children are bulk billed under the CDBS, and we can check your child's remaining balance with Medicare before treatment begins.
Checking the balance yourself
You can see if your child is eligible, and how much of the cap is left, in your Medicare online account through myGov, and a participating practice can also check it for you. Have your child's Medicare card handy when you book, and tell the practice you would like to use the CDBS.
Getting the most out of two years
Booking the first check-up early in the window gives your dentist or OHT time to find any problems while they are small and to plan treatment within the cap. Preventive care, such as cleans, fluoride and sealants on newly erupted molars, tends to cost the scheme little and may avoid larger fillings later. If the treatment your child needs is more than the remaining balance, your dentist can talk through priorities and timing.
If your child has never been to the dentist, our guide to a child's first dental visit explains what happens and how to prepare them.
Questions families ask
Can we use the CDBS at a private practice?
Yes. Both public and private dental services can provide CDBS treatment, as long as they participate in the scheme. Confirm with the practice when you book, and ask whether they bulk bill.
Does it matter if my child also has private health insurance?
Children can be eligible for the CDBS whether or not the family holds private health cover. The same service cannot be claimed from both the CDBS and your fund, and your fund cannot top up a CDBS benefit. Health insurance can still help with services that are billed outside the scheme, such as orthodontics.
Our letter never arrived. Can my child still be eligible?
Yes. The letter is a notification, not a requirement. Check your Medicare online account through myGov, or ask the practice to confirm when you book.
Booking with the CDBS
Our dentists and oral health therapists see children of all ages at Lumi Dental in Melrose Park, and we are happy to confirm eligibility for you when you call. You can read about routine children's care on our general dentistry page or see family offers on the deals page.
This article is general information and not a substitute for personal dental advice; confirm current CDBS details with Medicare.
