Dental prostheses
Do you need a new tooth or prosthesis? Then the costs can increase. Fortunately, there are refunds.
Health insurance reimburses removable dental prostheses under certain conditions. And this applies to the upper teeth, the lower teeth and both together.
Are you not receiving reimbursement for your prosthesis from your health insurance? Then you are entitled to a CM refund. And this for both fixed and removable prostheses.
Health insurance
Health insurance is mandatory in Belgium. Everyone who contributes can enjoy it.
CM benefit
In addition to the mandatory health insurance, as a CM member you receive additional benefits.
Health insurance | to request
A refund is only possible for removable dentures. This applies to the upper teeth, the lower teeth and both together.
In many cases this is done electronically and you do not have to take any action yourself. Will you still receive a certificate for the assistance provided? Please deliver this to CM as quickly as possible.
What is the condition?
- Be fifty years or older.
- The age requirement does not apply for certain conditions or in specific situations. Your dentist can check whether you qualify for this.
Health insurance | refunds
You are simply insured
with oral care programme: 452,00 tot 679,50 euros
without oral care programme: 396,00 tot 626,50 euros
You have VT
with oral care programme: 559,00 tot 844,00 euros
without oral care programme: 557,00 tot 842,00 euros
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The oral care process means that reimbursement for most dental care is better for those who regularly visit a dentist than for those who do not. 'Regular' means that the patient received dental care in the previous calendar year that was reimbursed.
A refund is possible per jaw and per seven calendar years. The calendar year of the installation of the prosthesis counts as the first of the seven calendar years.
You are simply insured
with oral care program:
for first tooth: 175,00 euros
per additional tooth: 46,50 euros
without oral care program:
for first tooth: 154,50 euros
per additional tooth: 37,50 euros
You have VT
with oral care program:
for first tooth: 196,00 euros
per additional tooth: 56,50 euros
without oral care program:
for first tooth: 195,00 euros
per additional tooth: 55,50 euros
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The oral care process means that reimbursement for most dental care is better for those who regularly visit a dentist than for those who do not. 'Regular' means that the patient received dental care in the previous calendar year that was reimbursed.
Reimbursement is limited per prosthesis to a ceiling value that corresponds to the value of a complete prosthesis. The amount of reimbursement may therefore be lower than the amounts stated in this table, if the ceiling value has already been reached.
You are simply insured
with oral care programme: 121,00 euros
without oral care programme: 100,50 euros
You have VT
with oral care programme: 142,00 euros
without oral care programme: 141,00 euros
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The oral care process means that reimbursement for most dental care is better for those who regularly visit a dentist than for those who do not. 'Regular' means that the patient received dental care in the previous calendar year that was reimbursed.
Repairs to the prosthesis are paid out up to once per calendar year.
You are simply insured
with oral care programme: 186,50 euros
without oral care programme: 166,00 euros
You have VT
with oral care programme: 199,00 euros
without oral care programme: 198,00 euros
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The oral care process means that reimbursement for most dental care is better for those who regularly visit a dentist than for those who do not. 'Regular' means that the patient received dental care in the previous calendar year that was reimbursed.
Replacement of the base to which the teeth are attached is paid out up to twice per jaw (lower and upper jaw) and per current period of seven calendar years.
Important
- In most cases, a fixed dental prosthesis or a 'dental bridge' is not reimbursed . Reimbursement is only provided in certain cases for patients who require complex dental repairs due to cancer or anodontia (complete absence of permanent teeth).
- In the event of serious dysfunction of the removable full lower denture, a one-off reimbursement may be possible from the seventieth birthday, under strict criteria, for:
One of these criteria is that, when the implants or abutments are placed, you must wear a removable full lower denture on a completely edentulous lower jaw for at least 12 months (when no visible teeth or tooth roots are present).
Code: 308512
You are simply insured
fee: 2.197,50 euros
with oral care programme: 1.756,50 euros
without oral care programme: 1.716 euros
You have VT
fee: 2.197,50 euros
with oral care programme: 2.112,50 euros
without oral care programme: 2.110,50 euros
Code: 308534
You are simply insured
fee: 2.061,50 euros
with oral care programme: 1.620,50 euros
without oral care programme: 1.580,00 euros
You have VT
fee: 2.061,50 euros
with oral care programme: 1.976,50 euros
without oral care programme: 1.974,50 euros
CM benefit
Do you need a removable or fixed prosthesis such as a crown, bridge or implant? Then, as a CM member, you are entitled to a refund of 40% of the costs for purchase and installation, up to 1,050 euros per 2 calendar years (in case of supplemented refunds: 75% with a maximum of 1,050 euros). For prostheses placed before January 1, 2024, the reimbursement is 60% instead of 40%, with the same maximum amount of 1,050 euros.
Request proof
Ask your healthcare provider for proof of reimbursement under the CM dental benefit. You should not print this form yourself and give it to your healthcare provider.
The Riziv provides the form 'Harmonization document' or 'Support for treatment(s) carried out' for this purpose.
Deliver to CM
Deliver the completed form via a CM mailbox or the My CM app .
What are the conditions?
- Be a member of CM.
- There is no right to reimbursement from statutory health insurance for removable dental prostheses.
- Under certain conditions, health insurance will reimburse these prostheses. This is legally described. Are you eligible for reimbursement from health insurance? Then the statutory rates apply and there is no reimbursement from the CM benefit.
- There is no application for reimbursement via the Technical Dental Council.
- The reimbursement applies to the placement of new fixed prostheses (crowns, bridges and implants on which a fixed prosthetic device is placed), new removable prostheses and for additional placements on existing removable prostheses. The refund does not apply to rebasings, nor to repairs. Overview of the services that are eligible or not.
- The prosthesis is delivered by a dentist recognized by the Riziv.
- Repayment of up to 1,050 euros is possible every two calendar years. How is the refund calculated over two calendar years?
Extra information
Curious about what average cost and average reimbursement you can expect for a dental prosthesis? We list the most common treatments and their cost.
Any questions? View the frequently asked questions or contact CM.