Dental care benefit

All insured adults are entitled to up to 60 euros per year in dental care benefit (with a 50% co-payment).

A benefit of up to 105 euros per year (with a 12.5% co-payment) is available for pregnant people and mothers of children under one year of age, old-age pensioners, pensioners receiving a pension for incapacity for work, persons with partial or no work ability, persons over the age of 63, patients with an increased need for dental care, people registered as unemployed with the Unemployment Insurance Fund, and recipients of subsistence benefits who have received such benefits during the two calendar months prior to the month of receiving dental care.

The dental care benefit is an in-kind benefit, meaning the invoice is settled electronically between the dental care provider and the Health Insurance Fund.

If the service is eligible for the benefit, the reimbursable amount will be deducted from the invoice at the time of payment, and no separate reimbursement is made by the Health Insurance Fund.

The benefit applies to essential dental care services. For services that are not included in the list of reimbursable services, the full price according to the clinic's price list must be paid.

The dental care benefit can be used at dental clinics that have a contract with the Health Insurance Fund.

If the invoice is 50 euros, the person pays 50% as a co-payment – i.e., 25 euros – and the Health Insurance Fund reimburses the remaining 25 euros (50%).

As the annual benefit limit is 60 euros, the person would still have 35 euros left to use during the same calendar year.

The dental care benefit must be used within a single calendar year. Any unused amount does not carry over to the next year. When the new year begins, the benefit calculation starts anew.