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        Community health centers

        Article Community health centers are group practices where you can call on different healthcare providers.

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        Can I receive a refund from CM-MediKo Plan in addition to the reimbursement from the CM benefit?

        FAQ
        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%. 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.
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        Can I receive a reimbursement for the CM dental benefit in addition to the health insurance reimbursement?

        FAQ
        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.
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        How is my reimbursement for dental prostheses calculated?

        FAQ
        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%. 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. Example calculation over two calendar years Performance year Prosthesis Paid CM refund 2021 Crown 834 euros 500 euro (60% of the purchase and installation costs) 2022 provisional Crown 250 euros 150 euros (60% of the purchase and installation costs) Crown 1,500 euros 400 euros (60% of the purchase and installation costs, less refunds 2021 and 2022; or 1,050 euros - 500 euros - 150 euros = 400 euros ) 2023 2 crowns 1,750 euros 500 euro (60% of the purchase and installation costs
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        Is it true that you don't have to wait for the benefits reimbursement of dental prostheses?

        FAQ
        Indeed. It is sufficient that you are a CM member at the time the treatment starts. So there is no waiting time.
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        What do I need to do to get my denture reimbursement?

        FAQ
        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.
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        Which dental prostheses are eligible for the dental prostheses benefit?

        FAQ
        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
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        Does the reimbursement for dental prostheses apply to every CM member?

        FAQ
        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 .
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        How much does a dental prosthesis cost?

        Reimbursement It can happen to anyone: an unfortunate fall while cycling, serious gum disease or a tooth that can no longer be reconstructed after several treatments. The costs of replacing a tooth can be high, because not all types of dental prostheses are reimbursed.

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