How can I use the high-cost protection?
High-cost protection is for individuals who have high dental care costs. This means that once your costs exceed a certain amount, you only need to pay for part of the cost yourself.
You can receive dental care compensation through the high-cost protection if you
- turn at least 23 years of age during the year
- are insured in Sweden. You are if you live or work here. There are some exceptions to this rule.
Even if you reside in a country other than Sweden, you may be eligible for compensation through the high-cost protection in certain circumstances.
What can I use my high-cost protection for?
Your dentist or dental hygienist is obliged to let you know whether your treatment entitles you to compensation from high-cost protection or not. It applies for most treatments, but there are exceptions.
For example, you cannot receive compensation for teeth whitening, other forms of cosmetic dental care, or for dental care that is part of an agreement for subscription dental care.
Dental care that is part of treatment for an illness is not covered by the high-cost protection for dental care. Such dental care is subject to the county council’s regular patient fee and the county council’s high-cost protection for patient fees. For more information about this, please contact your county council or region.
How much do I get?
Any costs with a reference charge of up to SEK 3,000 you must pay yourself. You then receive compensation for
- 50 per cent of costs with a reference charge between SEK 3,000 and 15,000
- 85 per cent of costs with a reference charge that exceeds SEK 15,000.
The compensation is not calculated based on the price charged by the dentist. It is instead based on a reference charge. The reference charge is a fixed price set by the government for all procedures – i.e. examinations and treatments – eligible for compensation from the national dental care subsidy. The charge includes costs of materials.
The dentist or dental hygienist does not have to follow the reference charge. They can charge more or less if they like. The compensation will be based on the reference charge, even if your dentist or dental hygienist charges a higher price for a procedure than the reference charge. If they charge a lower price, the compensation will be based on the price you actually paid.
For some treatments, you can only receive compensation equivalent to getting a filling, even if you choose to have a crown fitted to fix the tooth. Similarly, for some treatments you can only receive compensation for a bridge, even if you choose to get an implant instead of a bridge. The dentist is obliged to let you know what applies in each individual case.
If you use your general or special dental care allowance to pay for part of your dental care costs, the allowance is detected before the high-cost protection is calculated.
High-cost protection is calculated year by year. This means that all procedures you have done during a consecutive twelve-month period are included in the high-cost protection.
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.
How do I use my high-cost protection?
To be able to receive compensation through the high-cost protection, you must go to a dentist or dental hygienist affiliated with the national dental care subsidy. Most are.
You do not need to apply for the compensation. Your dentist or dental hygienist will deduct it from your bill.