Reimbursement for dental care
Verified 15 May 2024 - Directorate for Legal and Administrative Information (Prime Minister)
How much of your dental consultations and care will be reimbursed? The dentist consultation is covered by the Health Insurance up to 60%. Dental, prosthetic and orthodontic treatments are reimbursed, but are subject to special rates. We'll tell you the main amounts you need to know.
The difference between the amount paid and the amount reimbursed by the Health Insurance can be supported by your health complementary if the contract you have entered into so provides.
Find out from her.
The rules vary depending on whether or not the consultation takes place in Alsace-Moselle.
Indeed, in Alsace-Moselle, the local health insurance scheme provides complement the general scheme's payment of health costs.
General case
Visits to a dentist are covered by the Health Insurance and reimbursed to 60% on the basis of conventional tariff (sickness insurance).
The stomatologist is a physician to whom the flat-rate contribution of €2. This participation remains at your expense at each consultation or medical act.
The contracted doctor in sector 1 applies the tariff fixed by agreement with the sickness insurance, while the contracted doctor in sector 2 charges a free fee.
Consulted Practitioner | Rate | Reimbursement Basis | Amount Refunded | |
|---|---|---|---|---|
Dental surgeon | General case | €23 | €23 | €13.80 |
Specialized in ODF: titleContent | €23 | €23 | €13.80 | |
Stomatologist | Sector 1 | €31.5 | €31.5 | €20.05 |
Sector 2 | Fees free | €23 | €14.10 | |
Alsace-Moselle
Visits to a dentist are covered by the Health Insurance and reimbursed to 60% on the basis of conventional tariff (sickness insurance).
The stomatologist is a physician to whom the flat-rate contribution of €2. This participation remains at your expense at each consultation or medical act.
The contracted doctor in sector 1 applies the tariff fixed by agreement with the sickness insurance, while the contracted doctor in sector 2 charges a free fee.
Consulted Practitioner | Rate | Reimbursement Basis | Amount Refunded | |
|---|---|---|---|---|
Dental surgeon | General case | €23 | €23 | €13.80 |
Specialized in ODF: titleContent | €23 | €23 | €13.80 | |
Stomatologist | Sector 1 | €31.5 | €31.5 | €20.05 |
Sector 2 | Fees free | €23 | €14.10 | |
Warning
The local health insurance scheme in Alsace and Moselle ensures a complement the general scheme's payment of health costs.
Dental care includes
- Preservative care (scaling, treatment of decay, devitalization...)
- And surgical care, like extraction.
They are reimbursed to 60% on the basis of conventional tariff (sickness insurance).
These rates are different where they are carried out:
- On adults
- Or on the permanent teeth of children under the age of 13.
Dental care is not subject to the lump sum payment of 2. €
However, they are subject to this participation if they are performed by an stomatologist.
Dental rates are not the same for people over the age of 13.
From the age of 13
Dental care | Conventional rate | Reimbursement rate | Amount Refunded |
|---|---|---|---|
Descaling | €28.92 | 60% | €17.35 |
Treatment of Caries on One Side | €26.97 | 60% | €16.18 |
Treatment of Two-Sided Caries | €45.38 | 60% | €27.23 |
Devitalization of an incisor or canine | €33.74 | 60% | €20.24 |
Milk tooth extraction | €25.00 | 60% | €15.00 |
Permanent tooth extraction | €33.44 | 60% | €20.06 |
Under 13
Dental care | Conventional rate | Reimbursement rate | Amount Refunded |
|---|---|---|---|
Treatment of Caries on One Side | €31.20 | 60% | €18.72 |
Treatment of Two-Sided Caries | €52.50 | 60% | €31.50 |
Devitalization of an incisor or canine | €39.04 | 60% | €23.42 |
Devitalization of premolar | €55.77 | 60% | €33.46 |
Devitalization of molar | €94.80 | 60% | €56.88 |
Repayment Terms
Dentures are reimbursed to 60% on the basis of so-called liability tariffs, very often lower than their actual cost (free tariffs).
The dental surgeon or oral surgeon is required to inform you in advance by means of a written estimate that you will sign, if necessary, for acceptance.
This quote must include, including:
- Precise and detailed description of the treatment envisaged and/or the materials used
- Fee amount for salary
- Amount reimbursed by the Health Insurance.
Dental care performed by an stomatologist is subject to the flat-rate contribution of €2.
Rates and Refunds
Denture | Rate | Refund Basis | Maximum amount over base rate | Refund Rate | Maximum amount refunded |
|---|---|---|---|---|---|
Crown | Fees available | €120.00 | €142.50 | 60% | €157.50 |
Dentin (1 to 3 teeth) | Fees available | €64.50 | €210.50 | 60% | €165.00 |
Complete Dentist (14 teeth) | Fees available | €182.75 | €545.25 | 60% | €436.80 |
Bridge of three elements (2 pillar teeth + 1 intermediate element to replace an absent tooth - the pillar teeth must be damaged) | Fees available | €279.50 | €470.73 | 60% | €450.14 |
Supporting Conditions
Orthodontic treatments or treatments ODF: titleContent (often called rings) are covered by the Health Insurance provided that:
- To obtain theprior agreement from your health insurance fund
- Starting treatment before 16e birthday.
The dental surgeon or oral surgeon is required to inform you in advance by means of a written estimate that you will sign, if necessary, for acceptance.
This quote must include, including:
- Accurate and detailed description of the proposed treatment and/or materials used
- Fee amount for salary
- Amount reimbursed by Health Insurance
- Possible supplements.
FYI
Exceptionally, the child over 16 years of age may be covered by the Health Insurance for one semester of treatment, before surgery on the jaw. This semester is not renewable.
Request for prior approval
First, you and your dentist or stomatologist fill out a specific form depending on the care prescribed.
You must then send this form to the medical service of your CPAM: titleContent.
Rates and reimbursement of orthodontic treatments
Treatment | Rate | Reimbursement Basis | Maximum amount over base rate | Reimbursement rate | Maximum amount refunded |
|---|---|---|---|---|---|
Treatment per semester (maximum 6) unattached | Fees free | €193.50 | €139.50 | 100% | €333.00 |
Supervisory session (maximum 2 per semester) | Fees free | €10.75 | €0 | 60% | €6.45 |
Contention 1st year | Fees free | €161.25 | €0 | 100% | €161.25 |
Contention 2nd year | Fees free | €107.50 | €0 | 60% | €64.50 |
FYI
The orthodontic treatment is subject to the flat-rate contribution of €2 it is performed by an stomatologist.
Who can help me?
Find who can answer your questions in your region
Health Info Rights
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By Form
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From this form, you can request to be called back.
Setting of tariffs by interministerial orders
Dentists' Agreement with Health Insurance
Rates for Dentists and Certain Dental Care
Rates and reimbursement conditions
Participation of the health complementary
Service-Public.fr
Service-Public.fr
National Health Insurance Fund (Cnam)
National Health Insurance Fund (Cnam)