Orthodontics
Does your child need braces (orthodontic treatment)? Then the costs can increase.
There are two types of reimbursement for orthodontics: one by health insurance and one by CM. That means you're on top the reimbursement from the health insurance if a CM member receives an additional CM reimbursement.
Health insurance
Health insurance is mandatory in Belgium. Everyone who contributes can enjoy it.
CM advantage
In addition to the mandatory health insurance, as a CM member you receive additional benefits.
Health insurance
Is your child younger than 9 years old and does he need braces (= early orthodontic treatment)? Then you can receive a refund from your health insurance.
That refund is for the correction of:
- the frontal and lateral crossbites;
- the frontal and lateral coercive bites;
- the position of the incisors as prevention of anterior trauma;
- the lack of space during the transition phase.
The reimbursement is a fixed allowance amount of 341 euros (or 432 euros for patients with increased reimbursement).
What should you do?
- Did your orthodontist give you a certificate for the care provided? Deliver this to CM on time : certainly before your child's 9th birthday.
- The refund will be made in two instalments . You will be refunded half of the amount at the start of the treatment. The other half will be refunded at the end of the treatment.
- This reimbursement (for early orthodontic treatment) is a one-off . This means that you can only request them once.
What is the condition?
Your child is younger than 9 years old.
Up to the age of 22, health insurance will cover the costs of orthodontics (traditional or regular orthodontics). The amounts are fixed , whatever the techniques and equipment used.
Research for possible treatment
normal allowance: 40.00 euros
VT : 50.50 euros
The research involves collecting data and producing the study models.
Analysis of the data and drawing up a treatment plan
normal allowance: 31.50 euros
VT : 42.00 euros
Regular treatment after device placement
normal allowance: 20.00 euros
VT : 26.50 euros
Two sessions per calendar month are reimbursable, with a maximum of six sessions per six calendar months. A maximum of 36 refunds are possible during the entire treatment.
Contention review hearing
normal allowance: 14.00 euros
VT : 20.50 euros
Maximum four repayments per calendar year; a maximum of twelve refunds in total possible.
Fixed allowance for the device
normal allowance: 166.50 euros
VT : 212.00 euros
This amount is paid out twice: once after the installation of the device; a second time after the first six sessions of regular treatment (at the earliest the sixth calendar month of treatment).
What should you do?
- During the treatment, immediately pass on all certificates of care provided (which you receive from the orthodontist) to CM.
- You can do this via the My CM app.
What are the conditions?
Will you receive your orthodontic appliance (your braces) before your 15th birthday ?
- Send your certificate to CM before your 15th birthday.
Do you get your orthodontic appliance (your braces) after your 15th birthday?
- Before your 15th birthday, let CM know that you will be getting braces. That's called a notice. Do you get a certificate for that? Be sure to deliver that certificate to CM before your 15th birthday.
- Your orthodontic treatment will start no later than 24 (calendar) months after you have informed CM (the notification), unless the notification states otherwise (notification).
- Reimbursement of orthodontic costs is only possible up to the age of 22.
Request a certificate
CM requires a certificate for assistance provided to reimburse you for this benefit.
Deliver certificate to CM
Have you received a certificate for assistance provided ? Deliver that to CM.
Be sure to do this before your child's 9th birthday if it concerns early orthodontics, and before your child's 15th birthday if it concerns classical orthodontics. Your orthodontist can also send it directly (electronically) to CM.
What are the conditions?
- Your child is a member of CM.
- The treatment entitles you to reimbursement from your health insurance (early orthodontics or traditional regular orthodontics).
- The treatment starts on or after January 1, 2021. The performance date of the installation of the first device is decisive (performance code 305631 or 305933).
- You do not interrupt the treatment yourself.
CM advantage
As a CM member you will receive a 60% refund on the co-payment and supplements. The reimbursement amounts to a maximum of 1,050 euros. If your allowance increases, you will receive a 75% refund. The reimbursement also amounts to a maximum of 1,050 euros.
The refund:
- applies to early orthodontics for children under 9 years of age and to classical regular orthodontics;
- can be requested only once in a life time for a total amount of 1,050 euros;
- can be requested by submitting the "Proof of Treatment(s) Document." You will receive this harmonization document from the orthodontist. You can submit multiple harmonization documents until you reach the maximum amount of 1,050 euros.
- is in addition to reimbursement by health insurance.
Request proof
CM requires proof to reimburse you for this benefit. You can ask your orthodontist for this proof. Your orthodontist can use a form from the RIZIV for this. This form is called 'Harmonization document' or 'Support for treatment(s) carried out'.
Send the form to CM
Return the completed form to CM. You can also send it via the My CM app .