As parents, we constantly strive to provide the best for our children, and their health is paramount. This extends beyond regular check-ups and nutritious meals to include crucial aspects like dental care. In Australia, two primary avenues exist to help manage the costs of children’s dental care: the CDBS (Child Dental Benefits Schedule) and private dental insurance.
This blog delves deep into the intricacies of both options, weighing their pros and cons to help you determine which path offers superior benefits for your child’s oral health journey.
Child Dental Benefits Schedule (CDBS)
The Child Dental Benefits Schedule is a government program that aims to make essential dental care more affordable for eligible families with children aged between 0 and 17. Administered by Services Australia, the CDBS aims to improve the oral health of children of families who meet specific eligibility criteria.
Key Features of the CDBS
Eligibility
To be eligible for the CDBS, a child must be aged between 0 and 17, be eligible for Medicare, and be part of a family receiving certain Australian Government payments, such as Family Tax Benefit Part A. Eligibility is assessed each calendar year.
Benefit Cap
The CDBS offers a dental benefit of up to $1,132 per eligible child over two years. It’s important to note that any portion of this allocated amount cannot be carried over if unused within two years.
Covered Services
The Child Dental Benefits Schedule provides coverage for several key dental services, such as:
- Dental check-ups and examinations
- Teeth cleaning
- Fluoride treatments
- Fillings
- Fissure sealants
- X-rays
- Root canal treatments
- Extractions
Direct Billing
Many dentists who accept the CDBS offer direct billing. This means they can bill Medicare directly for the services provided, and you may only need to pay the gap if the service cost exceeds the remaining balance of your child’s CDBS entitlement.
No Waiting Periods
Generally, there are no lengthy waiting periods to access services under the Child Dental Benefits Schedule once eligibility is confirmed.
Private Dental Insurance for Children
Private dental insurance, on the other hand, is a voluntary health insurance product that individuals or families can purchase to help cover the costs of dental treatments. Unlike the CDBS, private dental insurance involves paying premiums regularly in exchange for coverage on a range of dental services.
Key Features of Private Dental Insurance
Premiums
Policyholders pay regular premiums, which can vary significantly based on the level of coverage chosen, the insurer, and family circumstances.
Waiting Periods
Most private dental insurance policies have waiting periods before claiming certain benefits. These waiting periods can range from a few months for general dental to longer periods (e.g., 12 months) for major dental work like orthodontics or complex restorations.
Levels of Coverage
Private dental insurance offers various levels of coverage, from basic plans that primarily cover preventative care to comprehensive plans that include major dental work and orthodontics. Plans with greater coverage generally have higher premium costs.
Benefit Limits
With most private dental insurance, there’s a maximum amount, known as the annual benefit limit, that the insurer will pay for dental treatments each year. Once this limit is reached, you must cover the remaining costs out of pocket.
Gap Payments
Even with private dental insurance, you will often need to pay a “gap” fee, which is the difference between the dentist’s charge and the amount your insurance policy covers. The size of this gap can vary depending on your policy and the dentist’s fees.
Choice of Provider
Generally, private dental insurance allows you to choose your own dentist, although some policies may offer preferred provider networks with potentially lower out-of-pocket costs.
CDBS vs. Private Dental Insurance
To effectively determine which option is better for your child, let’s compare the CDBS and private dental insurance across several key aspects:
| Feature | Child Dental Benefits Schedule (CDBS) | Private Dental Insurance |
| Eligibility | Means-tested; based on receiving specific government benefits. | Available to anyone willing to pay premiums. |
| Cost | No premiums; government-funded for eligible families. | Requires regular premium payments. |
| Coverage Scope | Primarily basic and essential dental services. | Varies depending on the policy; can include major work and ortho. |
| Benefit Limit | $1,132 over two consecutive calendar years. | Annual limits vary by policy and insurer. |
| Waiting Periods | Generally, none. | Common, especially for major treatments. |
| Gap Payments | May occur if the service cost exceeds the remaining benefit cap. | Often occurs; the amount depends on the policy and the dentist’s fees. |
| Choice of Dentist | Generally allows choice, provided the dentist accepts CDBS billing. | Generally allows choice, but preferred providers may reduce costs. |
| Complexity | Relatively straightforward to understand and access for eligible families. | Can be complex due to varying policy options and terms. |
Which Option is Better for Your Child?
There’s no single “best” choice between the CDBS and private dental insurance. It depends heavily on your individual circumstances, financial situation, and your child’s dental needs.
When the CDBS Might Be Sufficient
Eligibility is met
If your family meets the eligibility criteria for the Child Dental Benefits Schedule, it offers a valuable and cost-free way to access essential dental care for your child.
Focus on basic care
If your child generally has good oral health and primarily requires preventative care like check-ups, cleanings, and the occasional filling, the CDBS may adequately cover these needs within its benefit cap.
Budget constraints
For families on a tight budget, the CDBS provides crucial financial relief for dental care without the added burden of regular premium payments.
When Private Dental Insurance Might Be More Suitable
Ineligibility for CDBS
If your family does not meet the eligibility criteria for the Child Dental Benefits Schedule, private dental insurance becomes a viable option to help manage dental costs.
Need for extensive or specialised care
If your child is likely to require more extensive dental work, such as orthodontics, crowns, or bridges, which are either not covered or have limitations under the CDBS, private insurance with a higher level of coverage can be beneficial.
Desire for higher annual limits
If you anticipate your child needing more than $1,132 worth of dental treatment over two years, the higher annual limits offered by some private insurance policies might provide better financial protection.
Making the Right Choice for Your Family
Choosing between the CDBS and private dental insurance requires careful consideration. Here are some questions to ask yourself:
- Are we eligible for the Child Dental Benefits Schedule? Check the Services Australia website to see if your family qualifies.
- What is our budget for healthcare expenses? Can we comfortably afford private dental insurance premiums?
- What are my child’s current and potential future dental needs? Are they likely to need more than basic care?
- What level of coverage do we need? Compare different private insurance policies and their benefits.
- Are we comfortable with potential waiting periods and gap payments associated with private insurance?
It’s also wise to consult your dentist about the available options. They can provide insights into your child’s oral health needs and potential future treatments, helping you gauge whether the CDBS, private dental insurance, or a combination of both is the most suitable path to protecting your child’s precious smile.
Parkmore Family Dental proudly supports families by offering bulk billing through the CDBS and helping parents navigate their options with ease. As a trusted provider under the Government Dental Scheme, we ensure your child receives gentle, high-quality dental care, whether you’re eligible for CDBS or rely on private dental insurance.
Not sure which dental funding option suits your family? Contact Parkmore Family Dental today and let our friendly team guide you.
