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Dental care: how to benefit from 100% Health? What treatments are reimbursed?

SUMMARY :

What is 100% Dental Health?

Since 1er January 2020, the100% Health offer gives access to a large choice of dental crownsof bridge and dentures (since 1er January 2021). All of these products are fully reimbursed : this is dental care for which patients have nothing to pay.

It is added to the offer for hearing aids and the glasses.

What treatments are covered by 100% Dental Health?

The 100% Health offer concerns everyone care basket :

  • Porcelain-to-metal crowns and one-piece ceramic crowns for visible teeth;
  • Metal crowns for all teeth;
  • Porcelain-to-metal bridges for the replacement of an incisor;
  • All-metal bridges for all teeth;
  • Resin dentures (removable prostheses) for all or part of the teeth;
  • Repairs or changes to denture components.

Who is concerned by the 100% dental health?

Anyone benefiting from a responsible contract by his mutual insurance company can benefit from the 100% dental health offer. The responsible contract now represents 95% of the contracts sold on the market: it provides for ceilings and floors for coverage.

100% Health dental care: how to benefit from it?

The 100% dental health offer is available from all dentists : the latter are obliged to offer you an estimate with a treatment plan specifying the care to be carried out in the 100% Health basket.

There are three baskets for dental care:

  • the 100% Health basket, or crowns, bridges and dentures which are fully reimbursed if you benefit from a mutual insurance contract which provides for it, or a “responsible contract”. This basket covers the essential and most common prosthesis needs with no extra charge, and guarantees access to materials of an aesthetic quality adapted to the tooth being treated;
  • the basket at moderate prices, i.e. crowns, bridges and dentures whose prices are capped. Depending on the complementary health insurance, there may be a chargeable but moderate remainder;
  • the basket with free prices with the most sophisticated techniques and materials. Depending on the mutual, the rest to be paid may be more important.

The estimate made by your dentist must mention the type of basket selected. Each patient is obviously free to choose 100% Santé or the therapeutic alternative that suits them. The dentist making the estimate is also not obliged to carry out the treatment himself: he can send his patient to another specialist.

Dental care: what has changed with the 100% Health reform?

Before the 100% Health reform, the average price of a ceramic crown was around 550 euros. On average, the reimbursement by health insurance and complementary health insurance amounted to around 355 euros: there was therefore 195 euros payable by the insured. Since 1er January 2021, the remainder payable is nil for the insured.

For ceramic bridges, the remaining charge could sometimes amount to 650 euros for the patient. For a denture the remaining charge could amount to 572 euros, the remaining charge is now at 0 euros.

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