Dental Care Benefits Scheme
The present system for dental care benefits was introduced on the 1st of July, 2008. In January 2013 it was extended to include an additional grant system for certain groups of patients.
The Dental Care Benefits Comprise:
- A general dental care grant
- A specific dental care grant (for certain groups of patients)
- A high-cost protection scheme
The general dental care grant is intended to encourage adults to regularly visit their dentist for check-ups and preventative care. The grant is either 150 SEK or 300 SEK, depending on age.
The specific dental care grant is intended to provide additional support to patients having a higher risk of developing dental problems, due to certain diseases or disabilities.
The general and specific dental care grants are both regulated by the government.
The High-Cost Protection Scheme
We regulate the high-cost protection scheme, and decide what dental procedures are reimbursable.
For each dental procedure reimbursable under the high-cost protection scheme a reference price is calculated. The reference price is the maximum compensation payable for an individual dental procedure.
If the dentist charges a higher price than the reference price for a dental procedure, the exceeding cost is paid by the patient.
Treatment costs up to 3 000 SEK is paid by the patient in full. For treatment costs above this level, high-cost protection scheme compensation is payable;
- 50% of treatment costs with a reference price between 3 000 and 15 000 SEK; and
- 85% of treatment costs with a reference price of over 15 000 SEK.
A Compensation Period Consists of Twelve Months
The high-cost protection is valid for a compensation period of twelve months. The compensation period starts from the date a reimbursable dental procedure is finalized.
At the request of the patient, the care provider can register the start of a new compensation period before the previous period has expired. This may be the case if the patient is about to start an extensive treatment and wants the whole treatment covered within one compensation period.
A Co-operation between Several Government Agencies
The TLV is responsible for changes to the high-cost protection scheme, and effectively decides which dental care procedures should be reimbursed, and calculates the reference prices for the reimbursable dental care procedures.
The Social Insurance Agency is responsible for information to dentists on regulations, and provides general information on the benefits system to individual patients.
The National Board of Health and Welfare provides regulations regarding which conditions need to be met to be eligible for the specific dental care grant.
The Healthcare Advice service "1177", responds to general enquiries on dental care from individual patients.