“100% Health”: Instructions For Full Reimbursement Of Dental Prostheses
Dental Prosthesis: the rest at zero charge, what is it?
The cost of dental care is a drag for many French people . According to a Health and Social Protection (ESPS) survey by Birds “Waivers of care in 2012”, one in six French people renounce it for this reason. The fitting of prostheses is particularly concerned. Indeed, the remaining charge could vary between 195 and 545 euros after reimbursement of the Health Insurance.
Since January 1, 2020, the “100% health” offer (or remains at zero charge) has made it possible to remedy this. The goal: to offer prostheses whose prices are capped and which will be fully reimbursed.
Who can benefit ?
Everyone affiliated with Social Security , which has a complementary individual health or business or the supplementary Universal Health Coverage (CMU-C), free complementary health reserved for the poorest, can benefit the rest to zero load.
Be careful for this to work, the complementary health must be said to be “responsible”, which means that the contributions are not based on the state of health of the beneficiary. This concerns a large majority of them (around 95%) but it is always better to make sure of this upstream.
What is the procedure to follow ?
All you have to do is go to your dentist to ask for a quote for the care to be performed. The latter must mention:
The precise care to be carried out as well as the materials used;
The place where the prosthesis is made;
The amount of the fees for the treatment as well as that covered by the Health Insurance;
If the dentist enters a metal prosthesis in the estimate and does not carry it out himself, this must be specified.
The patient then sends this estimate to his complementary health .
3 treatment baskets available
The “100% health” basket, fully reimbursed: this basket offers essential and most common care;
A basket at controlled prices : it provides moderate out-of-pocket expenses by limiting the prices of certain dental prosthetic treatments;
A basket at free prices : this concerns in particular the most innovative techniques or in the event of particular aesthetic requirements, the patient and his dentist can decide together to resort to treatments for which there is no price cap. .
The final choice of care is up to the patient.
What treatments are concerned with “100% health”?
The products offered are the same as before this reform . If eyeglass manufacturers design them adapted to this offer, dentists for their part work with prostheses that must be made to measure , so there will be no change in this regard. A wide choice of fixed prostheses is offered in the “100% health” offer:
Monolithic ceramic crowns (other than zirconia) and metal-ceramic crowns on visible teeth (incisors, canines and 1st premolar);
- Zirconia monolithic ceramic crowns (incisors, canines and premolars);
- Metal crowns any location;
- Core inlays and transient crowns (linked to definitive crowns);
- Ceramic-metal bridges (incisors);
- Metal bridges any location;
- Removable resin-based prostheses.