Since January 1, some dentures can be fully reimbursed through the reform, 100% health. Explanations.
heal is expensive. It takes 500 to 900 euros for a ceramic crown, with a rest to support the middle that goes from 195€ to 545 € (after reimbursement of health Insurance and health insurers) for many insureds. Result : many give up on this type of care. To curb this phenomenon, the State has engaged in a major reform which, for the most part, can be deployed in 2020 and will be of benefit to all. Only requirement : have an additional health of the individual or the company, or of the new Complementary health solidarity has replaced since last November 1 the CMU-C and ACS (aid to the payment of a complementary health).
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Prices for some acts prosthetic
For dental care, an agreement for two sides was signed in 2018 with the unions of dental surgeons. On the one hand, the basics of reimbursement by health Insurance of some dental care (treatment of tooth decay, scaling, etc.) have been revalued. On the other hand, and it was the counterpart, the professionals have agreed to reduce and/or cap the prices of some of their dental prostheses. This measure came into force at the beginning of the year 2020.Your support is essential. Subscribe for $ 1 support Us
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Three offers the choice
Specifically, what is it that is changing ? Instead of a single and same offer for rates, "free", usually high and variable from one dentist to another, you will now be able to choose a dental prosthesis from among the three baskets of care : a basket says 100% health, a basket, said rates are controlled, and a cage that looks just like the one existing until now. To help you see clearly, every health professional has the obligation to prepare a detailed quote mentioning, if this is the case, the actions are achievable without the rest to support in the framework of the 100% health, or those achievable with a rest load to be controlled.
The basket 100% health
This basket contains only the devices that you will be fully and jointly reimbursed by the health Insurance and your supplemental health. Their characteristics have been determined on the basis of the location of the tooth to be treated : to the teeth, also called teeth in the smile (incisors, canines, and first premolars), you can benefit from a crown in metal covered with ceramic of which the ceiling price was set to€ 500.
For the incisors and canines, you can choose a ceramic crown is a monolithic zirconia at a maximum price of 440€.
For the other teeth finally, the full support will only apply to metal crowns, with a maximum price of€ 290.
in addition, this basket includes bridges metal-ceramic for front teeth (in the limit of a ceiling price of 1465€), of zirconia or metal the other teeth (in the limit of a ceiling price of 870€).
On January 1, 2021, it will be supplemented by prostheses made of resin.
The basket rate-controlled
The principle of this second basket of care is very clear : to offer a wider choice to patients, but in the limit of certain price ceilings, in order to reduce as much as possible the rest to load. If, for example, to questions of aesthetics you prefer a metal-ceramic crown and not a crown of metal (as provided by the basket 100% health) to style a second premolar, you will not be able to benefit from a full support for this prosthesis. But, in the framework of the basket rates are controlled, you can benefit from a price ceiling, since the dentist may not charge more than 550 €. For a crown with a zirconia on a molar, the price ceiling has been set at 440€.
Attention, however, because here, the health insurers are not obliged to a full refund of your expenditure : your share of the cost will therefore depend on the level of guarantees is more or less your additional health.
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As its name suggests, this basket has all sorts of equipment the prices of which continue to be freely fixed by the surgeon-dentist. In particular, are concerned the implants, crowns on implants, or crowns full ceramic. Even more than previously, the final cost that you will have to take will obviously depend on the generosity of the guarantees (often expressed in the form of a package) of your health insurance.