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Last Updated on 17 December 2018

Dental Guide for Kids


Child and Dental Health

Say Cheese! A healthy smile is an important part of your overall health, and good dental hygiene starts when you’re young. That’s why it’s so frustrating that Australia’s Medicare system doesn’t offer much in the way of dental health care for kids.

Dental care can be expensive, especially if your child needs orthodontics. Fortunately, private health insurance offers a range of dental coverage, so your kids can have sparkling smiles without taking a bite out of your budget.

Key Points
  • Medicare offers limited dental coverage for eligible children under the Child Dental Benefits Scheme, which is capped at $1000 over a consecutive two-year period.
  • Extras cover is a type of private health insurance that includes varying levels of cover for children’s dental services.
  • Parent feedback suggests that Medicare should provide more support for kids’ dental, but private health insurance goes some of the way towards closing that gap.

What Does Medicare Offer for Kids’ Dental?

The Child Dental Benefits Scheme (CDBS) covers basic dental services for children aged 2 to 17 years. To be eligible, your child must be part of a family claiming certain eligible benefits, such as Family Tax Benefit Part A.

You can claim up to $1000 over a consecutive two-year period for your child’s eligible dental services. If you do not claim the full $1000, it does not roll over. If your child is still eligible for the CDBS after the initial two-year period, you may be able to start a new benefits period.

As someone who doesn’t love her teeth, I definitely wish Medicare included dental.
Not for my sake but for my kids, so they are able to gain access to the dental care that I didn’t have.

Often the cost of dental care is forced to the bottom of a family’s budget. This is not because we don’t want to provide dental care for our kids, but because it costs so much! The cost of living is increasing year by year and costs much more than ever before.

As a society we are also consuming foods and drinks that are not beneficial to our dental, or overall health too. Even when we think we are making the right choices, you find because of labelling or advertising, we have been misguided and you’ve been unknowingly damaging your teeth.

Poor dental hygiene and diet also influences diseases that we face later in life, and this impacts on our healthcare system in a negative way. If people are educated, it will help to stem the flow on effects to the health care system, which will be a good thing for everyone.

A dentist doesn’t just fix teeth – they help shape and encourage us all to live a healthier lifestyle.

I am however very grateful for the current $1000 provided by our government to look after our kids’ dental hygiene. I am concerned though that if any of our children need braces that we won’t be able to afford it.

Fee Dixon

“I believe that kids dental services (particularly x-rays, check ups, preventative services and cleaning) should be bulk-billed through medicare. Ideally everything, including fillings, orthodontics and other services to correct or repair kids teeth should also be included on the schedule to provide parents with some financial relief.

Dentists and Orthodontists can be very expensive and if you have more than a couple of children those costs mount up rapidly. Early intervention will help prevent further medical issues stemming from dental diseases and will assist in reducing dental costs down the track.”

Kirsty at My Home Truths

“As a parent, I strive to give the best care to my kids in terms of their health and wellbeing. I see dental care as part of this. Being in Queensland, we are fortunate to have the dental vans visit schools, which I think is a brilliant initiative. The regular check ups and education available underpins the children’s dental health for their life. We are just entering the orthodontic period of parenting with, so far, 2 of our 4 kids needing extra work done on their teeth and it does put pressure on the family budget. It would be great to see more funding in this area to help families.”

Kelly at Be a Fun Mum

“We think dental care is vitally important for children, not just for their immediate dental health but because oral hygiene habits are formed early in life. A quick search revealed that about 39% of the Australian population have a healthy dental regime and 61% have a poor regime.

To improve those statistics, habits need to be established early. The Queensland government does offer a free dental service for children aged 4 up to grade 10. However, it is only available at specific clinics and cuts out before children are independent of their parents. A lot of families would feel more comfortable keeping with their family dentist – we certainly would.

It would be of huge benefit if Medicare covered an annual clean and check-up for children up to the age of 18, at a dentist of the family’s’ choice.

For further dental work, a safety net could be implemented, similar to the one that currently exists for medical bills. Orthodontic and other dental bills can pile up quickly, and for some families the financial pressure is too much to bear. With braces costing up to $8,000, some financial assistance, perhaps means tested, would certainly be welcomed by many families.

As a country, we believe that we can afford to support dental health for ALL our kids. It’s also about prevention. Surely investment in children’s dental health will lead to reduced costs in the future and an increase in our nation’s’ overall adult dental health.”

Sarah and Robyna at Mummy and the Minx

How Much Does Kids’ Dental Cost?

The cost of dental care in Australia isn’t standardised, so providers set their own prices. As a result, prices can vary and it can be hard to know what is reasonable.

Even if you are eligible, the price of kids’ dental care can quickly surpass the $1000 CDBS cap, and if you have more than one child, costs can get out of control very quickly.

Children should start seeing the dentist within six months of growing their first tooth, with regular checkups thereafter. Avoiding the dentist to save money isn’t a reasonable option, which is why many families use private health insurance as a solution.

Extras Cover for Kids’ Dental

Extras cover is a type of private health insurance for the day-to-day services you receive out of hospital. There is a whole spectrum of reasons why you might need dental coverage for your child, from benign regular check-ups to fixing up a tooth after a collision on the sports field.

“We tend to perceive teeth as being all about the ‘Hollywood Smile’, but the further reaching implications on overall health & wellbeing are considerable. Often overlooked due to cost, the health of the teeth is essential not only for confidence, but also affects the foods consumed, and the flow on effects of lack of adequate nutrition and all that goes with that.

Pressure to obtain orthodontic care for looks alone is an expense we don’t need. However, if it is to correct or encourage healthy behaviours, and for overall health, it’s worth the cost, especially long term. Having assistance for individual families to cover these expenses is important, but the long term savings for public health are considerable.”

Amanda

Teeth are so important and keeping them healthy isn’t just about appearances. I think that all kids, regardless of how much their parents earn, should be able to access dental care because tooth pain and the resulting infections can be a horrible experience for a child.

I also think that the free dental needs to be about preserving teeth rather than taking the quickest and often most painful route which is what the current adult system is. Having a positive dental experience when young can be the difference between a child learning to take care of their teeth and avoiding the dentist once they are old enough to make the decision themselves.

Tegan

Most extras policies offer a range of dental cover, so you can select the level of coverage that suits your family’s needs. When comparing extras policies for kids’ dental cover, it helps to know what you’re looking at.

General or Major Dental?

You’ll probably come across the phrases ‘general dental’ and ‘major dental.’ General dental is for minor services like fillings, and may even include preventative treatment like check-ups and cleanings. Most basic extras policies will include general dental; this level of cover usually suits young, healthy people who visit the dentist once or twice per year.

Major dental is a step up, and covers your child for services like root canals, oral surgery or tooth extractions. Depending on the policy, it may also include orthodontics or dental implants. Major dental is popular with families and seniors.

Annual limits

After you determine which level of dental cover you are interested in, consider the policy’s annual limits for dental services. An annual limit is the maximum amount you can claim back each year for the dental services your family receives under the policy.
Keep in mind you’ll need to look at two different tiers of annual limits:

  • Individual limit: A per-person limit
  • Family limit: Combined limit across everyone covered by the policy

For example, an extras policy may offer a $500 individual limit and a $1000 family limit. For a family of four, that means that not every family member could reach their full individual limit.
The higher your level of coverage, the more generous the annual limits tend to be. These limits reset each year, and unused benefits do not roll over.

Claim-back percentages

Your policy will usually allow you to claim back a certain percentage on your dental services. Basic-level cover may only let you claim back 55%, while comprehensive cover could have a 100% claim-back allowance. Many funds offer high claim-back rates on children’s dental services, though annual limits still apply.

Waiting periods

Be mindful of waiting periods when you purchase a new extras policy for your family. There are usually waiting periods for certain dental services, and you may have to wait several months or longer before you can make a claim.

Provider network

Your fund’s provider network is a collection of health professionals who have an agreement with the fund. You can sometimes claim higher benefits received from an in-network provider, so a larger provider network gives you more dentists to choose from.

What about orthodontics?

Although orthodontics is undeniably related to your child’s teeth, it is sometimes classified as their own section in extras cover. If you’re looking for orthodontics cover, be sure it is included in the policy. Lifetime limits often apply to orthodontics; once you hit the limit, it does not reset even if you change insurers.

Is Private Health Insurance for Kids’ Dental Worth It?

We asked mums and dads for their thoughts on Medicare and private health cover for kids’ dental care. Their answers varied, but one thing was clear: our kids’ dental health is important, and parents are doing what they can to keep it a priority.

“My 3 year old son was diagnosed with a congenital condition which caused his baby molars to decay. The pain woke him up, screaming, in the middle of the night. The first question the paediatric dental specialist asked us was, ‘Do you have private health insurance?’ Fortunately our answer was ‘yes’ and he got the treatment he needed immediately. My heart goes out to the parents who have to answer ‘no’ to that question.”

“My children are still young (two and five) but dental costs in the future, particularly if they need orthodontic work, is a bit of a worry and part of the reason we’ve taken out private extras cover.

I feel Medicare could help cover some of the costs of preventative dental checkups for children as the cost of going to the dentist, even for the most basic of visits, is a real deterrent for some families. By helping with the costs of preventative dental, this will hopefully reduce the need for more major dental work in future.

Medicare’s Child Dental Benefit Scheme is a step in the right direction, but $1000 would probably not go very far if a root canal or an extraction was needed. I think providing more financial assistance over a longer time frame would be more beneficial. Orthodontic work is a huge cost to families and with no benefits offered by Medicare, many families simply can’t afford it. Some assistance for orthodontic work would be a big help.”

With four children at all different stages of their dental development, I am finding that I need to visit the dentist more than ever. My thoughts are that the more we protect their dental health now and help to prevent problems from developing, the healthier the children will be in the long term.

It’s amazing to think just how important dental care is for children and adults and I feel very strongly that if we educate and support families with their dental health that we will create a healthier and happier Australia.

I’d love to see a little more support for those children who need a bit more than just the basic check-ups and maintenance. With all of my children heading down the path of orthodontics, I am a little worried about the costs involved and the impact this will have on our family.

Natalie

I love my kids and as they are boys they are happy to try and get out of cleaning their teeth if at all possible as it gets in the way of a good play!

Coming from the UK, I was really surprised to find that here in Australia, dental care for children has to be paid for as it is free back in the UK.

I hear that dental vans visit schools in Queensland, and I think that’s a great idea. I’m sure parents would be happy to book time during the day to visit the dentist – I know I would!

Whatever the incentive or initiative, visiting the dentist really should be free for our kids as it can be a drain on the family budget.

Simon at Fast Lane Dad

We’ve always had private health insurance and accessed their Dental Clinics. Now we live in a rural area and access the University Dental clinic -only for fillings and checkups. Both my sons (aged 8) will need orthodontic services to correct their jaw alignment and to adjust their teeth / jaw. Orthodontics has limited coverage even with Top Health cover.

In an ideal world, fillings and orthodontics etc should all be included on the Medicare schedule to provide disadvantaged families with a measure of financial relief. Whether it is means tested, subsidized ($1000) or even as a tax rebate (the Govt. has changed eligibility for net medical expenses tax offset; restricting who can claim and what medical expenses can be claimed).

Kids’ teeth are the last thing that people consider on a budget. Early intervention and education will help to reduce preventable medical and social issues stemming from dental disease. Good teeth are essential for confidence, speech and overall health. As a paediatric nurse 15yrs ago, I saw many children under 5 with all of their teeth being removed under general anaesthetic.

“I think it’s extremely important that all Australian children have access to health and dental care, and I’m thankful that our local dentist is able to bulk bill my children’s dental hygiene checks. If Medicare didn’t cover children’s dental care, then I’m sure there would be children in the community who were simply not able to access it due to financial reasons. These children would be incredibly disadvantaged being that many problems can be prevented by regular checks and cleans.

As for orthodontic care, I suppose I have always been resigned to the fact that we would need to use our health insurance to cover orthodontic work, as our parents did before us. Of course it would be nice if Medicare was able to cover braces and other orthodontic work, but there are other life-saving prescription medications that are currently available – but not covered by medicare – that I would like to see be covered first.”

Aanika

“I think that adequate dental cover is an essential part of any person’s health and wellbeing management plan – and this is especially the case for children. It’s unfortunate that it can be so expensive, and I have known many people who have had to wait a long time for treatment in the public system. Anything that can be done to decrease waiting times, while being less of a financial burden on parents or carers, would be helpful.”

Karen at Misc Mum

“Whilst we have to be conscious of the cost to the government, I think it’s so important for a high standard of healthcare to be available to children from all walks of life. Poor dental care as a child could lead to greater costs (and burden) on the health system later in life. Not to mention the lifelong impact to the child from being self-conscious about what their teeth look like! There is so much financial pressure on families just to cover general living expenses and health insurance isn’t affordable for everyone. Covering a broader range of dental services under Medicare will ensure more families have access to an adequate level of healthcare to their children.”

Kristy at Lou Lou Zoo

Disclaimer: The above information is correct and current at the time of publication

Frequently Asked Questions About Health Insurance

There are three types of health insurance in Australia. They are:

  • Hospital Cover
  • Extras Cover (also known as general or ancillary cover)
  • Ambulance Cover

Hospital cover can ensure any unexpected surgeries, treatments or hospital stays you may require will be covered. With appropriate cover you will have the flexibility to choose your own doctor and the option of receiving treatment in a private hospital.  Most hospital covers allow you to stay in a private room. One other perk is skipping the public hospital systems’ waiting list, which can be lengthy for non emergency treatment.

Extras cover pays benefits for a a range of services, often including treatments and procedures related to the fullowing:

  • Dental/oral health
  • Glasses and contact lenses
  • Podiatry
  • Physiotherapy
  • Psychulogy
  • Acupuncture
  • Remedial massage
  • Chiropractic
  • Hearing aids
  • Travel vaccinations

Ambulance cover, as the name suggests, will cover you should you require emergency ambulance transport. In an emergency, there is enough to worry about. Having the expenses covered for provides security and peace of mind. Many hospital covers include emergency ambulance transport If yours doesn’t, you will need to shop for this separately.

Life is unpredictable. You never know when you might need cover. No matter what life stage you’re in, there’s a policy out there for everyone. You can select as much or as little cover as you want, depending on your health needs and requirements. It’s a small price to pay for the peace of mind health cover provides.

There is no one answer here. Costs vary across providers and policy types. Just because a policy is cheap, that does not mean it is ‘value for money’ and vise versa. Make sure you check what’s included and excluded in a policy before signing up, as you want to purchase a policy that best fits your specific needs.

Premium: A premium is the price you pay for your insurance policy (it may be paid annually or on an ongoing basis).

Policy: An insurance plan. In other words, it is the type of insurance you choose to select.

Policy Holder: The owner, or ‘holder’ of a policy.

Claim: In the event that you require treatment for a service covered by your policy, you can lodge a claim for reimbursement of all or part of the cost of that treatment.. These days, most claims are submitted electronically by the health care provider (dentist, physio etc)

Lifetime Health Cover: Lifetime Health Cover was put in place to encourage young Australians to seek out and maintain ownership of private health insurance early in their lives. If you do not take out a policy before you turn 31, extra charges will be applied should you take out a policy at a later time.

This means you will pay a 2% loading on top of your premium for every year that passes after you turn 30. For example, if you take out a policy for the first time at age 32, you will be charged 4% of your premium as an extra, then at age 40, 20% and so on, up to a maximum loading of 70%.

The loading is payable for 10 consecutive years of cover - after which it is removed and you premiums will be reduced.

Pharmaceutical Benefits Scheme (PBS): Medicare offers assistance for Australians with many of their their prescribed medication costs through the PBS. This assistance is in the form of subsidies towards the cost of many medications. You can check if your prescribed medication is on the list of subsidised items here.

Medicare Levy Surcharge: The Medicare Levy Surcharge is an additional charge (tax) applied to single Australian taxpayers who earn over the income threshold of $90,000 per year, or families/couples who earn over $180,000 per year. This surcharge is only applied to those who choose not to have a private health insurance policy.

The surcharge is designed to reduce pressure on the public health system by encouraging those with higher incomes to invest in private health cover.

Private Health Insurance Rebate: The government’s Private Health Insurance rebate lowers premiums for most Australians with private health insurance Older Australians may enjoy an even higher rebate. Our calculator can help you estimate the Government health insurance rebate you may receive.

Disclaimer: The above information is correct and current at the time of publication


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