If your child is eligible, Medicare will send a letter to them. There is no need to register or apply for the same.
In order to avail the benefits of CDBS, your child must comply with the following pre requisites:
- Your child should be between 0 to 17 years old, at least one day than the calendar year.
- Your child is eligible for Medicare.
- At least once in that calendar year, you or they get an eligible payment.
- You can be either the child’s parents or guardians, or an approved care organization.
On the other hand, if you are a teenager and have a partner, you might avail Medicare Child Dental Benefits, if you are 17 years old, or younger for at least one day in that calendar year. Otherwise, your partner gets an eligible payment from them.
For basic dental services under CDBS, Medicare covers 1026$ for over 2 calendar years. On a yearly basis, on the 1st day of January, the cap amount is indexed. A child or teenager who has received their first eligible service in that calendar year, the increase in cap will only apply to them. The services which are included under this are:-
- X Rays
- Fissure Sealing
- Root Canals
- Check ups
However, for the basic dental services, there are certain restrictions. Before availing of the Medicare Child Dental Benefits, you should always check with the dentist if there are any item or time limitations.
Also, these are the services that are not covered under this scheme:
- Cosmetic Dental Work
- Orthodontic Dental Work
- In a hospital, any type of dental services.
How to make use of the insurance?
Before visiting the Dentist
Just say that you want to make use of Medicare Child Dental Benefits, when you book an appointment with the dentist. To gauge the benefit that you can get, just check how close you are to the balance cap limit. You can also call the Medicare program or check your Medicare online account, if you are not left sure how much is left with you. Also, at the time of appointment, the dentist will check your child’s available benefit.
During the Visit:
Ask how much each service will cost, and whether Medicare Child Dental Benefits covers the services when you are on the appointment. Here, you will receive a consent form, where the list of services together with what they cost. . Just check them carefully, and if you agree, just put a sign of yourself.
Some dentist right on the day of the service, gives you a bill that you need to pay. You can them claim the benefit from Medicare. But, if the dentist bills in bulk, there is no requirement for claim or payment.
How to claim the Dental services offered by the Medicare Child Dental Benefits?
For the same dental service, you can either claim from the Medicare or a private health insurer.
The benefit can be claimed either to the dentist at the time of payment, and if the dentist does not bill in bulk, you can directly claim from the Medicare Before making an appointment, check to see if your dentist bills in bulk or not. You can also make use of the health service tool on the health direct website, to get hold of a dentist who bills in bulk.
In case where the dentist does not claim on your behalf, you can do so yourself by following any of the methods mentioned below:
- Through My Gov, from your Medicare Online Account
- Through Express Plus Medicare mobile app
- Fill a Medicare claim form, and take it to the service center
- Fill a Medicare Claim Form, and post it address on the form.
We will pay the benefits directly in your bank account, once we have processed your claim.
Now, that you have got an idea as to how Medicare Child Dental Benefits might prove useful for your child, why wait? Just get hold of this insurance scheme and keep away all your worries of your child’s dental health.