نموذج الموافقة الإلكتروني

Am I eligible for CDBS and how do I claim?

To be eligible, you or the child must be claiming one of the following benefits: Family Tax Benefits-Part A, Parenting Payment, Abstudy, Youth Allowance, Carer’s Payment, Disability Support Pension, Special Benefits or Double Orphan Pension. To enquire if your child is eligible, please contact Medicare on 132 011.

Once your child’s forms have been completed, we will individually check each child’s eligibility to see if treatment can be bulk billed through Medicare.

If my child is not eligible for the CDBS, how much does it cost?

If your child is not eligible for the CDBS funding, Teeth on Wheels can offer a check-up, clean and fluoride treatment (and x-rays if required) for only $99 per visit. If you have Private Health Insurance, Teeth on Wheels will provide you with an invoice after your $99 payment to claim your refund.

Please choose if your child had/has any of the following medical conditions. If you select a condition, please supply any further information.

I, the patient / legal guardian, certify that I have been informed:

• of the treatment that has been or will be provided from this date under the Child Dental Benefits Schedule;
• of the likely cost of this treatment; and
• that I will be bulk billed for services under the Child Dental Benefits Schedule and I will not pay out-of-pocket costs for these services, subject to sufficient funds being available under the benefit cap.

Declaration

• I understand that I/the patient will only have access to dental benefits of up to the benefit cap;
• I understand that benefits for some services may have restrictions and that Child Dental Benefits Schedule covers a limited range of services. I understand I will need to personally meet the costs of any services not covered by the Child Dental Benefits Schedule;
• I understand that the cost of services will reduce the available benefit cap and that I will need to personally meet the costs of any additional services once benefits are exhausted.