You may have a child who could use the Child Dental Benefits Schedule (CDBS) and a private health policy with extras cover. You want to know if both can help pay for the same visit.
Short answer: not both for the same service
Services Australia says you can't claim from it and a private health insurer for the same dental service. Chapman Road Dental Clinic in Geraldton says it explains findings, options and costs before arranging further treatment. Ask for that explanation before you agree to a plan.
Here is the rule in the words of the body that runs the scheme:
"You can’t claim from us and a private health insurer for the same dental service." Services Australia, How to claim the Child Dental Benefits Schedule, checked 27 October 2026.
The rest of this article covers what to check before treatment starts. It is general information about published guidance. It cannot say what your child is eligible for or what your fund will pay.
Eligibility, remaining balance and a quote are different checks
Parents often fold three questions into one. Each has its own source of answers.
- Is my child eligible? Services Australia sets the rules. Its Child Dental Benefits Schedule page lists Medicare, an age rule and an eligible payment. Eligibility is not automatic for every child.
- How much of the benefit is left? The cap applies over two calendar years, so earlier dental services may already have used part of it. Check the balance with Services Australia.
- What will this treatment cost? Ask the dental team for a written estimate, and ask your insurer what your policy pays.
The table shows where to take each question.
| Funding question | Where to ask |
|---|---|
| Is my child eligible for CDBS now? | Services Australia |
| How much of the cap is left, and when did the two-year period begin? | Services Australia |
| Which services are on the plan, and what are their item numbers? | The dental team |
| What will each item cost, and is there a gap? | The dental team, in a written estimate |
| Will my fund pay toward a given item? | Your private health insurer |
| Will this clinic bill CDBS for this visit? | The dental team, when you book |
Nothing in this table is a quote. This article gives no dollar estimates for a plan, because costs depend on the treatment, your child's balance and your policy.
What "same service" means for the questions you ask
The rule uses the words "same dental service". This article does not work out how a visit divides into services. It also does not say whether any particular mix of CDBS and fund claims is allowed. Those are questions for the dental team and your insurer, about your child's actual plan.
Try these questions, in this order:
- Which services are on the plan, and what are their item numbers?
- Which payer is proposed for each service, and is there a gap?
- Can I have that in writing before treatment starts?
- If my fund is involved, how do we make sure nothing is claimed from both it and CDBS?
If you call Chapman Road, you can say: "I'd like to understand how my child's dental benefit and my private health cover apply to this plan, so nothing is claimed twice."
Item numbers are worth asking for because they give you a precise reference when you speak to your insurer. A plain description such as "a filling" is less specific.
Different services: ask the dentist and your insurer
Do not assume your fund applies to a service that CDBS is not paying for. The Australian Government’s waiting-period guidance says: “Your policy will list the waiting periods that apply to you.” Ask your insurer before the visit. Ask the dental team how each item will be billed. Keep both answers in writing if you can.
Chapman Road's related article, Health fund questions to ask before dental treatment, covers the general questions for fund members. This article stays with how a child's benefit and a fund interact.
Treatment should follow your child's clinical need, as assessed by the dentist, not a funding calendar. Do not book extra treatment because a benefit is running down. If a plan includes an item you do not understand, ask why it is recommended and what the alternatives are.
What CDBS covers and what it excludes
Services Australia lists the basic services the scheme covers on its What's covered page. The same page lists what falls outside it: orthodontic care, cosmetic dental work and services provided in a hospital.
Two practical points follow.
- Read the official list for current detail. Other clinics' websites sometimes repeat older or local versions of the rules. Some describe public clinic arrangements, such as zero-fee care, that do not describe a private practice.
- If an item sits outside the scheme, CDBS is not the route for it. Whether your fund pays toward it is a policy question for your insurer. Ask the dentist for the item number so the answer is specific.
Whether a service suits your child is a clinical decision. The dentist can explain the findings and the options at the visit.
The two-calendar-year cap is not an annual reset
The CDBS benefit is a cap, not a voucher, and it is not a yearly amount. Services Australia says the cap applies over two calendar years, subject to eligibility and the remaining balance. For a period that begins with a first eligible service in 2026, the current page uses a cap of $1,158.
Keep that figure in perspective:
- It is a limit on what the scheme can pay. It is not a quote for treatment or a promised rebate.
- It is shared across the two-year period, so using some early leaves less for later.
- It belongs to a period that begins with a first eligible service in 2026. A different start year can carry a different cap, so check the official page instead of relying on a number you remember.
This is why the second check matters. If your child had services last year, part of the balance may already be used. Services Australia is the place to confirm both the balance and the start of the period.
Bulk billing and gap fees must be confirmed, not assumed
Services Australia notes that not all dentists bulk bill. A child being eligible for the scheme does not mean every clinic bills it in a way that leaves nothing to pay.
This article does not state how any visit at Chapman Road will be billed, and you should not assume an answer from this page. Ask when you book:
- Will this clinic bill CDBS for my child's visit?
- Is there any gap on the items in the plan?
- If my fund is involved for a different item, how will that item be billed?
Then ask for the answers in a written estimate. Chapman Road says it will walk you through its findings, your options and any costs before further treatment is arranged. That conversation is the place to make the billing arrangement clear before you agree to go ahead.
What Chapman Road asks families to bring
The children's dentistry page asks families to bring their child's Medicare card, medicine and allergy details, and any questions. For funding questions, these items also help:
- Your child's Medicare card, which is the starting point for the benefit.
- Your private health card, if you hold a policy that might apply.
- Any recent dental paperwork, such as an earlier estimate.
- Your child's medicine and allergy details.
- A short list of questions, including the funding ones above.
The new patients page asks you to call or book online and say it is your first visit, so the team can tell you exactly what to bring. If you are not sure what you need, ask when you call.
A pre-treatment funding checklist
Use this list before you agree to a treatment plan for a child. It is a set of questions to ask, not a guarantee of any outcome.
- Confirm current CDBS eligibility with Services Australia.
- Check the remaining balance and when the two-year period began.
- Bring Medicare and private health cards if applicable.
- Ask for item numbers and a written estimate.
- Ask which payer is proposed for each service, and any gap.
- Confirm the clinic's current CDBS and bulk-billing arrangements before relying on them.
- Ask your insurer separately whether it pays toward any item not claimed through CDBS.
When to contact us
To talk through your child's visit and these funding questions, call Chapman Road Dental Clinic on 08 9964 3577 or book online through the clinic's website. Tell the team it is your first visit if that is the case, and they will explain what to bring. The clinic is at 100 Chapman Rd, Geraldton WA 6530.
Frequently asked questions
Can I use CDBS for one service and my private health insurance for a different one? Services Australia's rule is about the same dental service, so a different service is a separate question. This article does not decide how services are divided or whether a combination is allowed. Ask the dental team and your insurer, using the item numbers on your child's plan.
Does the CDBS cap reset every year? No. Services Australia describes the cap as applying over two calendar years, subject to eligibility and the remaining balance. A new calendar year does not on its own start a fresh amount. Check the balance and the start of the two-year period with Services Australia.
Does Chapman Road bulk bill the Child Dental Benefits Schedule? This article does not state how any visit will be billed. Services Australia notes that not all dentists bulk bill, so ask when you book. The team says it explains findings, options and costs before arranging further treatment.
Is my child automatically eligible for CDBS? No. Services Australia lists eligibility conditions, including Medicare, an age rule and an eligible payment, so it is not automatic for every child. Check the current conditions on the Services Australia page before you rely on the benefit.
Sources and scope
General information only. This article reflects published guidance checked on 27 October 2026. It is not personal, clinical or financial advice. Rules, caps and fees can change, and your child's situation is individual, so confirm details with Services Australia, your insurer and your dentist.
- How to claim the Child Dental Benefits Schedule, Services Australia
- What's covered by the Child Dental Benefits Schedule, Services Australia, 2026
- Child Dental Benefits Schedule, Services Australia
- Waiting periods and exemptions, Australian Government, updated 26 April 2023
