High-cost protection for dental care
Subsidised dental care includes high-cost protection, which limits the amount that you have to pay for major dental work. Försäkringskassan pays compensation for the rest of the costs directly to your dentist; so you do not need to do anything yourself to benefit from the protection.
Compensation is based on a reference charge.
The high-cost protection means that you only need to pay a part of the cost yourself for major treatments. Försäkringskassan compensates the dentist directly.
But it is important to remember that the compensation from Försäkringskassan is not calculated based on the price the dentist charges. It is instead calculated on a reference price. The reference price is a fixed price set by the State. All treatments that entitle to compensation from the high-cost protection have a reference price. The charge includes costs of materials.
Dentists don’t have to follow the reference charge. They can charge more or less if they like. If your dentist charges more, Försäkringskassan pays the reference charge only. If your dentist charges less, Försäkringskassan pays that charge.
Read more about the reference price on the Dental and Pharmaceutical Benefits Agency website. A link is provided at right.
How does high-cost protection work?
You pay up to SEK 3,000 for dental work covered by reference charges. You then receive compensation as follows:
- 50% of the charges between SEK 3,000 and SEK 15,000
- 85% of the charges above SEK 15,000
If your dentist had charged more than the reference charge for any of the procedures, you would have paid more.
High-cost protection is calculated year by year
High-cost protection begins as soon as a procedure that it covers has been completed. All procedures performed over the following 12 months are covered.
You can choose to start a new compensation period before the old one expires. That might be to your benefit if you are about to undergo major dental work. Having several different procedures performed during the same period can bring you above reference charges of SEK 15,000 so that you receive more compensation for the remainder.