Dentists

What types of devices are covered?

To ensure that the treatment is effective, the dentist may choose different types of appliance depending on the state of the teeth and the corrections required.

The full list of dental procedures and services covered is set out in the nomenclature of dental procedures and services. I click here to access the nomenclature for dentists (list in PDF format).

Fixed or multi-attachment braces

In general, these are metal brackets that are commonly fitted to children. More rarely, and for aesthetic reasons, transparent ceramic or plastic brackets are used. In this case, additional costs are not covered by health insurance.

There is a lingual system bonded to the inside of the teeth. It is completely invisible, but requires time for the tongue to adapt and longer treatment. It is sometimes contraindicated, particularly when the teeth are too short.

Removable appliances

These take the form of clear resin trays that follow the shape of the teeth and palate and push the teeth into their ideal position.

What are the conditions for coverage?

A number of conditions must be met for cover to be granted.

The age of the beneficiary

Orthodontic treatment is only covered if my child starts it before the age of 17. The date on which the appliance is fitted is used to calculate the time limit and the age condition.

Orthodontic treatment for adults is therefore not covered.

A single cover

All orthodontic procedures (codes DT10 - DT62) are covered only once, with the exception of:

• code DT10 (orthodontic casts supplied to the health insurance fund), which may be reimbursed a maximum of 3 times over a 5-year period, with a minimum of 365 days between two DT10s,
• codes DT36 and DT46 (orthodontic treatment for cleft lip or labiomaxilla), which may be reimbursed a maximum of once per calendar year over a 3-year period.

Prior authorisation is required

Orthodontic treatment (except for positions DT10 and DT11) is only covered if it is carried out with prior authorisation and under the supervision of the Contrôle médical de la sécurité sociale (CMSS).

As a general rule, it is my dentist (in Luxembourg) who sends the application for prior authorisation to the CNS, together with all the supporting documents (estimate, moulds, etc.). The application is first checked by the CNS, then submitted to the CMSS for a medical opinion. If the CMSS gives a favourable opinion, the CNS sends me the agreement on the estimate itself. This agreement sets out the exact amount that the CNS will reimburse me.

Authorised orthodontic treatment must be started within 12 months of the date of authorisation by the CMSS. Once this period has elapsed, a new authorisation must be requested.

This 12-month time limit does not apply to authorisations for orthodontic treatment using mobile appliances or fixed appliances for cleft lip or labiomaxilla started before the age of 17 (DT36 and DT46).

How and at what rate am I reimbursed?

What factors can influence the price of a treatment?

1. Type of appliance: Metal, ceramic and lingual appliances all have different prices.
   
2. Complexity of the problem: The more complex the alignment problem, the more expensive the treatment will be.
3. Length of treatment: Orthodontic treatment generally lasts between 12 months and 2 years, depending on the case.

How can I find out how much my health insurance will cover?

My dentist sends the request for prior authorisation to the CNS, including an estimate. Once the request has been approved by the CNS, with the approval of the CMSS, the CNS sends the estimate back to me and my dentist, specifying the amount reimbursed.

What is the method of payment?

The costs of orthodontic treatment are invoiced in stages for defined periods (1^st period of 6 months, 2^nd period of 9 months, etc.). Orthodontic treatment is only reimbursed to the extent that the treatment has actually been completed.

As the parent of a child who has undergone orthodontic treatment, I pay the dentist based on the invoices issued for the specified periods and request reimbursement from the CNS.

Tariffs and rates of reimbursement

If my child has not reached the age of 18 at the time of invoicing, reimbursement is 100% of the nomenclature rates.

If my child has already reached the age of 18 at the time of invoicing, reimbursement is 88% of the nomenclature rates.

Good to know: An annual package of €77.35 (on 01.09.2023) is reimbursed at 100% for adults. This package is not limited to orthodontic treatment, but also covers other dental treatment (except prosthetic treatment).

What types of devices are covered?

Removable (or attached) prostheses

The choice of a removable denture depends on the number of teeth to be replaced and the materials used.

Partial dentures are held in place by clasps or attachments.

Full dentures work on the principle of juxtaposing two identical surfaces: the saliva between the gum and the plaque creates an ‘adhesive suction’ phenomenon. In other words, it acts as a natural glue!

Joint dental prostheses or fixed prostheses (crowns, bridges, etc.)

A crown reinforces a tooth that is no longer strong enough. A crown can also be used to anchor a bridge designed to replace one or more teeth.

A bridge is made up of crowned abutment teeth and elements that replace the missing teeth.

A pivot tooth completely replaces the visible part of the tooth and is fixed in the root.

What are the conditions for coverage?

A number of conditions must be met to be eligible for coverage.

Estimate

Some procedures carry the DSD symbol (dépassement sur devis), which allows the dentist to exceed the official tariffs, but only if they have presented me with a detailed estimate and with my consent. The dentist is free to determine the fees for these procedures 'with tact and moderation'.

Authorisation

In addition to the DSD symbol, some dental prosthesis procedures carry the ACM symbol (medical control authorisation). In this case, the prior estimate must be sent to the CNS, as it requires the agreement of the Contrôle médical de la sécurité sociale (CMSS). Usually, my dentist in Luxembourg will take care of sending the estimate to the CNS, or they will ask me to send it myself.

The application is first processed administratively and checked by the CNS, then submitted to the CMSS for a medical opinion. If the CMSS gives a favourable opinion, the CNS sends me the agreement on the estimate itself. This agreement sets out the exact amount that the CNS will reimburse me.

At the end of the treatment, I send the CNS the receipted invoice with the agreement on the estimate to request reimbursement of the amount indicated on the agreement.

Entitlement to a new dental prosthesis

Fixed prostheses

These prostheses are renewed every 12 years.

Removable prostheses

These prostheses are renewed every 5 years.

However, renewal times may be reduced by the Contrôle médical de la sécurité sociale (CMSS) in the following cases:

• maxillofacial bone fracture ;
• neoplasia affecting the maxillo-buccal region;
• very high-dose biphosphonate treatment;
• dental prosthetic treatment before the age of 17.

Special cases of coverage

Temporary dental prostheses

These prostheses are only covered if they are declared functionally essential by the Contrôle médical de la sécurité sociale (CMSS) and if the masticatory coefficient is less than fifty per cent.

Relining

Relining is the reshaping of the resin plate or skeleton to adapt the prosthesis to the mouth.

The total (DA75) or partial (DA74) relining of a removable prosthesis is covered once per prosthesis and per calendar year from the second relining.

How and at what rate am I reimbursed?

What factors can influence the price of a treatment?

1. Type of prosthesis: Partial, full or implant-supported prostheses cost different amounts depending on the material used and the complexity of the fabrication.
2. Number of teeth replaced: The more teeth to be replaced, the higher the cost.
3. Complexity of the case: Cases requiring specific adjustments or prior treatment, such as extractions, can increase the total cost.
4. Durability and comfort: Dentures of higher quality, offering greater comfort and durability, are generally more expensive.
5. Technology used: Prostheses made using advanced technology, such as 3D printing or digital scans, can also influence the price.

How can I find out how much my health insurance will cover?

My dentist sends the request for prior authorisation to the CNS, including an estimate. Once the request has been approved by the CNS, with the approval of the CMSS, the CNS sends the estimate back to me and my dentist, specifying the amount reimbursed.

How do I pay?

I pay the invoice directly to my dentist and request reimbursement from the CNS.

Tariffs and reimbursement rates

Dental prostheses are reimbursed at 80% of the official tariffs.

I do not have to pay the 20% personal contribution:

• If I can prove that I have consulted a dentist annually as a preventive measure during the 2 calendar years preceding the delivery of the prosthesis.
• For my child who has not yet reached the age of 18.
• For the renewal or repair of a total denture.
• For restorative maxillofacial prostheses.