Dental prostheses

Yes, dental prostheses are included as standard in CM's additional range of services and benefits . CM is committed to the health and well-being of everyone. Solidarity is the best guarantee to achieve that.

The specific conditions can be found on the page about the benefit . For additional reimbursement for dental care and other outpatient medical costs, you can take out additional insurance via CM-MediKo Plan .

When one or more teeth are effectively replaced, we call it a dental prosthesis. Both the prosthesis itself and the costs of installing it are eligible for the CM benefit. Supplements requested for a dental prosthesis for which reimbursement by compulsory health insurance is possible are not eligible (see below).

There are different types of prostheses or appliances that replace one or more teeth because they have disappeared or can no longer be reconstructed. The refund applies to the installation of:

• Removable prostheses:
  • upper denture;
  • lower denture;
  • additional placement of teeth on an existing removable prosthesis.
• Fixed prostheses:
  • implant: an artificial replacement of a tooth root. Where a tooth is missing, an implant with crown can be placed as a replacement;
  • crown: a cap made of ceramic and/or metal that fits over a ground tooth or molar and is glued to it or placed on an implant;
  • post tooth: an artificial dental crown that is attached to the root canal of the tooth with a post;
  • bridge: a dental bridge is a non-removable construction that replaces one or more absent teeth, attached to neighboring teeth or implants.

Below you will find for which prostheses the CM reimbursement does or does not apply (overview based on the harmonization document). Are you unsure whether you need a tooth replacement? Talk to your dentist or CM about it.

If no teeth are replaced, there is no reimbursement from the CM dental benefit. But possibly from CM-MediKo Plan, for example:

• only material is placed to better bond existing or removable dental prostheses (e.g. abutments and anchors);
• for other medical procedures (e.g. on the gums).

Indeed. It is sufficient that you are a CM member at the time the treatment starts. So there is no waiting time.

You will receive a 40%* refund for your submitted costs for the purchase and installation of your dental prosthesis. If you are entitled to supplemented refunds, you will receive 75%. For prostheses placed before January 1, 2024, the reimbursement is 60% instead of 40%.

* Subject to approval by the Health Insurance Fund Control Service.

This reimbursement is limited to 1,050 euros per two calendar years.

This means that we always calculate the sum of your reimbursements for the CM benefit for dental prostheses over a period of two calendar years. This may not exceed 1,050 euros.

For example, you are entitled to 1,050 euros every two calendar years. We keep track of all costs for you and calculate what you are still entitled to. For additional reimbursement for dental care and other outpatient medical costs, you can take out additional insurance via CM-MediKo Plan.

You need an application form from your dentist. For this we refer to the 'Harmonization Document' or 'Support for Executed Treatment(s)   because it was drawn up in consultation with all health insurance funds, dentists and the Riziv. This form also contains descriptions that do not qualify for the CM dental benefit.

Does your dentist provide a different form? Then we can accept this if it contains the necessary information to correctly calculate your refund.

No. Because there is already a partial reimbursement through the health insurance, there is no additional reimbursement through the CM dental benefit, not even for the non-refundable supplements requested on top of this dental prosthesis (e.g. frame, alley).

But with CM-MediKo Plan, your remaining costs after reimbursement by the health insurance are eligible. This falls within the cover for dental prostheses and implants and amounts to a maximum of 600 euros extra per year. In addition, CM-MediKo Plan also provides you with broader protection for dental care costs: dental prostheses with reimbursement by health insurance, orthodontics, periodontics, radiography, preventive and curative dental care, etc. Furthermore, this insurance continues to offer protection for other outpatient medical costs such as co-payments. , eye care, hearing aids, travel vaccines, nutritional and dietary advice and a childbirth allowance.

The CM benefit pays 40%* (or 75% if you are entitled to increased compensation) of your costs, up to 1,050 euros per two calendar years. For prostheses placed before January 1, 2024, the reimbursement is 60% instead of 40%.

* Subject to approval by the Health Insurance Fund Control Service.

The good news is that CM-MediKo Plan goes one step further. Because your remaining costs are eligible within the guarantee for dental prostheses and implants, up to a maximum of 600 euros extra per year.

And CM-MediKo Plan goes even further! Through CM-MediKo Plan you are also more broadly protected for the following dental care costs: orthodontics, periodontics, radiography, preventive and curative dental care. This insurance also offers protection for other outpatient medical costs such as co-payments, eye care, hearing aids, travel vaccines, nutritional and dietary advice and a childbirth allowance.