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How do mutual funds reimburse orthodontics?

Orthodontic treatments are not strictly reserved for children. They also represent an aesthetic and / or medical solution for many adults. The care at the orthodontist being high, subscribing to a good mutual is essential to reduce the amount of the bill. Have you decided to take the step and are wondering how complementary health care reimburses orthodontics? The answer to this question first requires a good understanding of reimbursement by Social Security.

Reimbursement of orthodontics by Health Insurance

Before going to an orthodontist in Paris, it is important to know that Social Security only reimburses care for patients under the age of 16. But to benefit from this support, you must also have obtained a prior agreement from the Health Insurance Fund. This implies during the first office visit to find out about the prior agreement request to be sent to it.

If, if agreed, the orthodontic costs will be reimbursed by your insurance, the coverage remains low. It is 70% of the tariff of the agreement if the acts are less than 120 euros and 100% of the tariff agreed if they are more than 120 euros. More specifically, the amount you can get from your insurance for the care your child will have received is 193.50 euros, which is very far from the 1300 euros that should generally be expected for treatment that is spread over 12 months.

With regard to adults, the disengagement from Social Security is even more serious. For these treatments at the orthodontist are not covered by Health Insurance. This is the reason why it is essential for the latter to choose their mutual health insurance carefully, the latter having to cover orthodontic care for adults so that the expenses can be reimbursed in whole or in part.

The reimbursement by the mutual fund of treatments at the orthodontist

Given the weakness or the absence of care by the Health Insurance care at the orthodontist it is advisable to choose his mutual well to get better reimbursements. The advice given on Magazine Assurance will help you make the right decision, a plethora of complementary health insurance available. If the reimbursement rates and times are not the same for all, the calculation method is generally the same.

In fact, in most cases reimbursement of care for children is equivalent to a percentage of the social security reimbursement base. With a complementary health insurance at 570% BR, the remainder of the charge may be 0 euros for a treatment that spans two years, ie for 4 semesters, compared to around 800 euros if you have not subscribed to a complementary health contract.

For an adult, reimbursement of the appliance prescribed by the orthodontist can reach 1500 euros per semester, excellent news if you have opted for one of the discreet solutions presented in this article . Thus, for example, for a two-year treatment billed at 2000 euros per semester, the complementary health insurance may reimburse up to 6000 euros in total, the rest of the charge for you being 2000 euros. Be aware that the reimbursement may not be a percentage and may be forfeited.

The reimbursement by the mutual fund of acts performed by the orthodontist is not complicated in itself. In case of need, do not hesitate to ask for further information from your supplement before taking action.


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