Dental care for people over the age of 20 - government dental care benefits scheme
Tandvård när man är över 20 år - statligt tandvårdsstöd – engelska

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Summary

Summary

The year you turn 20 you will have to start paying for your dental care

As from the 1 January of the year you turn 20 years old, you will have to pay for your dental care in most county councils. You will usually continue to receive appointments for check-ups, but otherwise you will have to schedule a time yourself with a dentist or dental hygienist.

Financial support for dental care

As from 1 July, 2008, you will start to receive dental care benefits the year you turn 20 years old. The benefits consist of two parts:

  • A general dental care grant, corresponding to SEK 150 or SEK 300 per year, depending on how old you are.
  • A protection threshold against high costs, which gives you a deduction if the ‘reference price’ you pay for dental care exceeds SEK 3,000 within a one year period.

You will not receive any grants or money in advance, but you will not have to cover the cost yourself as it is deducted when you pay for your dental care. The dentist or dental hygienist will then receive a reimbursement from the Swedish Social Insurance Agency.

The financial support applies to all check-ups and most dental care procedures. However, it does not apply to all your teeth, and not for procedures that are solely cosmetic, such as teeth whitening, facades or braces.

There are ‘reference prices’ on which the high cost protection is based. If the dental clinic’s price exceeds the reference price, then only the reference price will be counted towards your high cost protection.

Emergency dental care might be more expensive

Sometimes you need dental care immediately, and will have to seek emergency dental care. When you seek emergency dental care, you will usually have to pay for a more expensive check-up. In addition, it is often only the most acute cases that are admitted and treated. If you need additional dental care later on, you will have to pay for this as well. Furthermore, dental care is usually more expensive in the evenings and during weekends, which is during duty hours.

There are, however, dental clinics that have regular opening hours during evenings and weekends, and which do not charge extra at these times.

Choosing your dentist or dental hygienist

You can choose any dentist or dental hygienist you want, at any location you want. You can choose to receive dental care from the national dental health service or from a private clinic.

If you have been going to a dentist before, you can choose to continue going to this dentist.

In order to receive financial support, the dental clinic must be associated with the Swedish Social Insurance Agency, which most clinics are. If you want to find out whether the clinic is associated with the Swedish Social Insurance Agency, you can ask them when you make an appointment.

If you would like a list of dentists to help you find a new dental care provider, you can visit the national dental health service’s website or the website of private dentists.

Always ask what it is going to cost

Dentists and dental hygienists can set their own prices for check-ups and dental procedures. Since prices may differ between different dental care providers, and since there are comprehensive rules for the high cost protection, you should always ask for the price before any dental procedures. You have the right to know whether you are eligible for financial support.

If the treatment consists of several stages, or if you need multiple treatment sessions, then you have the right to be informed, in writing, of the total price and whether it will be counted towards your high cost protection. If it is difficult to state an exact price, then you still have the right to an approximate price, or an estimation of the minimum and maximum price.

Dental clinics are to have price lists displayed clearly in their waiting rooms, so that you can compare prices before your dental procedure. Some clinics also have price lists on their websites.

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General dental care grant

General dental care grant

A grant for everyone

As from the 1 July of the year you turn 20 years old, you have the right to an annual dental care grant. It is called the general dental care grant:

  • As from the year you turn 20 years old until the year you turn 29 years old, the grant is SEK 300 per year.
  • As from the year you turn 30 years old until the year you turn 74 years old, the grant is SEK 150 per year.
  • As from the year you turn 75 years old, the grant is SEK 300 per year.

You will receive a new dental care grant on 1 July every year. The grant is usually deducted when you pay for your dental care, but it might be a good idea to tell them that you want to use it.

You can save your dental care grant from one year to the next

You can save your grant from one year to the next and use two grants in one year, either at the same time or at two different occasions. However, it is not possible to save or use more than two grants at a time. For example, if you are 28 years old, you can save one year’s grant of SEK 300 and use both grants the following year, i.e. SEK 600.

If you are 29 years old, then you will receive SEK 300 that year, and SEK 150 the following year. If you save the first grant , then you will have SEK 450 the following year.

If you are unsure whether you have used your grant, then you can ask your dentist.

In addition, the general dental care grant can be used as payment for ‘dental care subscriptions’. Subscriptions are contracts where you pay premiums, and can be signed with the national dental health service or certain private dental clinics.

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High cost protection for dental care

High cost protection for dental care

High cost protection at a certain threshold 

In order to ensure that dental care does not cost too much, there is a high cost protection to support you after you have paid a certain amount for your dental care. This high cost protection is somewhat different from the high cost protection for healthcare, as the threshold is higher and the insurance only covers parts of your additional expenses.

Financial support for more expensive dental care 

Somewhat simplified, the high cost protection means that you pay the total cost for all dental care up to SEK 3,000, and then receive financial support that cover parts of your additional expenses. The more expensive the procedure, the greater the financial support. You will receive a price reduction of

  • 50 percent for expenses between SEK 3,001 and SEK 15,000
  • 85 percent for expenses over SEK 15,000

Dental care costs

Who pays?

Up to SEK 3,000

You paid the entire cost

Between SEK 3,001 and SEK 15,000

You pay 50% - the Swedish Social Insurance Agency pays 50%

Over 15,000

You pay 15% - the Swedish Social Insurance Agency pays 85%

Your dental care costs are accumulated over a 12-month period, after which they are reset. If your treatment is not completed within a 12-month period, you will start a new period and start paying your normal rate again. You are responsible for keeping track of the dates for these periods.

It is possible to reset the period and start a new one within less than twelve months. This might be beneficial if you, for example, have already started a period but will be soon undergo an expensive dental procedure that will continue past the final date of your current period. You cannot change the start date retrospectively.

Your dental clinic receives information from the Swedish Social Insurance Agency on how much of the dental care will by counted towards your high cost protection. If you switch dental care provider, your new provider will be able to see the current status of your high cost protection.

You can use your high cost protection as from 1 January of the year you turn 20 years old.

The more expensive, the greater the financial support 

Below are two examples of how the high cost protection affects how much you pay in the end.

Example 1:
You receive check-ups and treatments for a cost of SEK 10,000.
First, you pay SEK 3,000 yourself.
Then, you pay 50% of the cost between SEK 3,001 and SEK 15,000, which in this case is 50% of SEK 7,000 = SEK 3,500.
In total, you pay SEK 3,000 + SEK 3,500 = SEK 6,500.
Thanks to the high cost protection, you pay SEK 6,500 instead of SEK 10,000.

Example 2:
You receive check-ups and treatments for a cost of SEK 24,000.
First, you pay SEK 3,000 yourself.
Then, you pay 50% of the cost between SEK 3,001 and SEK 15,000, which in this case is 50% of SEK 12,000 = SEK 6,000.
Finally, you pay 15% of the cost that exceeds SEK 15,000, which in this case is 15% of SEK 9,000 = SEK 1,350.
In total, you pay SEK 3,000 + SEK 6,000 + SEK 1,350 = SEK 10,350.
Thanks to the high cost protection, you pay SEK 10,350 instead of SEK 24,000.

Not everything is covered 

There are rules that determine which check-ups, procedures and materials are covered by the high cost protection. If you choose a dental procedure that is not covered by the high cost protection at all, then you will have to pay for all the costs yourself. Sometimes, you can receive financial support for parts of the treatment.

Your dentist or dental hygienist has an obligation to inform you about which parts of the procedure are covered.

Which check-ups and procedures are covered?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The mouth is divided into four parts. Part one is the right side of the upper jaw, part two is the left side of the upper jaw, part three is the left side of the lower jaw and part four is the right side of the lower jaw. The teeth in each part are numbered from 1 to 8. Procedures involving tooth 1 to 6 are more or less always covered by the high cost protection.

Each tooth has a unique number based on in which part of the mouth it is located. For example, the teeth in part 3 are numbered 31, 32 ,33, 34 and so on. You have the right to financial support for all check-ups and most dental procedures. However, you do not receive financial support for cosmetic procedures that only improve the appearance of your teeth.

You will always have the right to receive treatment if you are in pain or suffer from illness, but you will not receive financial support for a root filling of a wisdom tooth.

If the ailment involves any of the twelve front teeth in the upper and lower jaw, then more or less all procedures are covered. If you need to fill a cavity, then the procedure is covered regardless of which tooth it is.

Removable dentures are always covered by the high cost protection.

Dental crowns are covered by high cost protection for tooth 1-6, if the tooth is seriously damaged. Tooth 7 is also covered if tooth 6 on the same side is missing.

When it comes to ‘bridges’ and implants, there are many in-depth rules that determine which teeth and which types of material are covered by the high cost protection. Therefore, we recommend that you ask your dentist.

A dental procedure consists of several parts 

A check-up or dental procedure usually consists of several different parts. For example, if you need to extract a tooth, then you will also need anaesthesia, antihaemorrhagic agents and possibly stitches in addition to the extraction. Check-ups and follow-up, such as removing stitches, are also part of the procedure.

Anaesthesia is always included when needed.

Sometimes it gets more expensive 

If you need a comprehensive dental procedure, it can sometimes be difficult for the dentist to estimate exactly how much dental care will be needed and how much it will cost. The suggested price may change if the procedure goes on for longer than initially planned. This could happen if there are complications or if the healing takes longer than expected, for example.

In these cases, you will have to pay for the additional dental care, but you have the right to receive this information as soon as the dentist finds out that your procedure will become more expensive.

Reference prices are the basis of the protection threshold against high costs 

The price charged by the dentist is not always the same as the amount that will be counted towards your high cost protection. The amount of financial support the you will receive is determined by ‘reference prices’.

The reference price is a set price that determines how much will be counted towards your high cost protection. It is not an average price or a recommended price that a dentist must charge.

All dentists and dental hygienists are permitted to set their own prices. If you use a dental clinic that charges a higher price than the reference price, then only the reference price will count towards your high cost protection. You will have to pay for the additional cost yourself. When a dentist or dental hygienist charges a price that is lower than the reference price, then it is always the lower price that will count towards your high cost protection.

Clinics will often charge a higher price for emergency dental care, but reference prices will still be the same as for scheduled dental care.

Reference prices are revised and changed every year.

The price list must be clearly displayed 

Even before visiting a dental clinic, you have the right to know the prices. There must also be a price list in the waiting room. The clinics are to show clearly the reference prices and their own prices, so that you can compared them.

If you have been examined and need several dental procedures, then you have the right to be informed, in writing, of what the procedures will cost and whether they will count towards your high cost protection. If it is difficult to state an exact price for a procedure, then you still have the right to an approximate price, or an estimation of the minimum and maximum price.

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Senast uppdaterad:
2016-11-15
Redaktör:

Editor: 

Ingemar Karlsson Gadea, 1177 Vårdguiden

Granskare:

Reviewed by: Barbro Hjärpe, dentist, the Dental and Pharmaceutical Benefits Agency, Solna,
Caroline Mårtensson, dentist, the Dental and Pharmaceutical Benefits Agency, Solna,
Lars Sjödin, dentist, the Dental and Pharmaceutical Benefits Agency, Solna

Illustratör:

Illustrator: Lotta Persson, illustrator, Gothenburg