Each mutual is different and offers different contracts. Mutuals providing attractive reimbursements have specific packages.ย Contact our administrative specialistย to help you in choosing your dental mutual that reimburses dental treatment abroad.
Reimbursement dental treatment
The terms of your reimbursements depend on the country where you are going and the type of dental treatment provided. Dental treatment is possible within the European Union and exceptional medical authorization may be granted by your doctor for treatment outside the EU, if you can establish with him the impossibility of receiving the necessary treatment in the member countries.
When you carry out your dental care abroad, the care that will be reimbursed to you must also be reimbursed in your country of origin. This is the principle of free competition of the European Union.
Thus the law provides:
This principle of reciprocity also works for patients from Luxembourg, Belgium or Germany Decree nยฐ 2005/386 of April 19, 2005 relating to the payment of care received in a countries of the European Union.
Prior authorization from your health insurance fund is not necessary to cover dental treatment whether it is carried out in France or in another EU state.
Reimbursement dental treatment
Among the dental treatment carried out abroad which is reimbursed by the Social security:
(Please note, your insurance fund disease checks your panoramic X-rays before and after, you cannot be billed for crowns if a bridge has been placed, you risk prosecution and fines).
Anveli Dental is located in European Union countries and works in line with CCAM codifications. Also, the amount of coverage for your care will be equivalent to that which would have been calculated for care provided in France.
Reimbursement dental treatment
To benefit from reimbursement from your social security, you must provide a complete file including:
You may also be requested in addition by your fund. ” health insurance:
Also, remember to keep all paid invoices and proof of payment and send them, accompanied byย form S3125ย Treatment received abroad (PDF), at your health insurance fund. You will be reimbursed on the basis of the current rates of the State of stay and within the limit of the expenses incurred.
Since January 1, 2020, there are three levels of coverage.
The three dental care baskets:
the prices of the “Rest at zero charge” and “Controlled prices” baskets vary according to the location of the tooth and the nature of the materials (metal ceramic or zirconia for the incisors, canines and premolars which are the most visible teeth, metallic for the back teeth)
Each patient is free to choose the therapeutic alternative that suits him best, having taken care to see the reimbursement conditions provided for in his complementary insurance contract for baskets at controlled and free rates.
From the 1st January 2021, 50 other fixed (crowns and bridges) and removable (dentures) prostheses will in turn be fully reimbursed.
Note: Please note, the remainder at charge 0 only applies if the dentist does not charge more than this. authorized capped amounts.
The total amount of frauds and scams at Social Security exceeds one billion euros in 2019, according to figures from the body responsible for identifying them. The scams alone represent more than 300 million euros.
Health professionals are not left out. Thus, many dental clinics, especially abroad, put their patients at great risk by providing them with false invoices. The diagram is simple: The patient asks for a quote for dental treatment that requires bridges on natural teeth or dental implants. Instead of being labeled and billed as bridges, the clinic says “dental crown”. The reimbursement of dental crowns is much better-taken care of, the mutual insurance company and social security give a much larger reimbursement amount and the patient, therefore, accepts the very advantageous estimate. After the completion of dental treatment, the patient sends his invoice to his health insurance fund and his mutual. This is where the problems begin for the patient who is expected to receive a very good reimbursement. The health insurance organization also asked for panoramic X-rays and very quickly realized that it was not a question of crowns but of the bridge. The patient then incurs a significant penalty.
From a criminal perspective, false invoices or those considered to be, fall within the scope of 3 criminal sanctions:
Our recommendation, to avoid falling under an administrative sanction, is to always ask for when you receive a dental quote indicating “crowns” if they are indeed crowns and not bridges.
Each mutual is different and offers different contracts. Mutuals providing attractive reimbursements have specific packages.ย Contact our administrative specialistย to help you in choosing your dental mutual that reimburses dental treatment abroad.
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