Treatment plan

Treatment plan

From 2004 the legal health insurance companies have to take over the treatments carried out in Hungary (EU) as well. The same grants are valid as in Germany or Austria. Though the people insured in Germany should get an approval from their health insurance in advance of the treatment.
After the treatment you get an invoice, which can be submitted at your health insurance. It depends on your personal insurance, how much the company will take over of the treatment costs. You will get information at your own health insurance company.

New regulations in connections with grants towards dentures

There are also changes in connection with the grants towards dentures: from 1st January 2005 the health insurance companies don’t pay the percentage share of a denture, but they provide a ‘fixed benefit grant’ based on dental findings’. For the patient this means that the payment of his/her health insurance company is oriented towards the dental finding from now, and not towards the method of treatment. So, if the patient would like to have a denture based on implants, instead of a bridge, he can decide himself, which acknowledged treatment he/she would like to choose - the health insurance pay the fixed amount in any case. Until now, if a patient would have liked a higher-quality medical care, he/she had to pay the entire costs out of their own pocket.

The amount of the standard care (fixed grants)

Resolution of G-BA (common federal committee) from 3rd November 2004 with the reservation of the examination by BMGS (Federal Department of Health)

Cost price: 1 Euro

No.	Finding	Fixed grant in euros
No.	Finding	without bonus	with 20 % bonus	with 30 % bonus	double FZSch. 1)
1.	Tooth worthy of preservation
1.1	Tooth worthy of preservation with extensive damage of the clinical crown or insufficient retention possibility, per tooth	115,27	138,32	149,85	230,54
1.2	Tooth, worthy of preservation, with large substance defects, but preserved vestibular and/or oral tooth substance, per tooth	129,36	155,23	168,17	258,72
1.3.	Tooth, worthy of preservation with extensive damage of the clinical crown or insufficient retention possibility in the facing area (15-25 and 34-44), per facing for crowns (based on implants as well)	41,85	50,22	54,41	83,70
1.4	Endodontical treated tooth with the requirement of a prefabricated metallic root pin with conventional cement method, per tooth	24,92	29,90	32,40	49,84
1.5	Endodontical treated tooth with the requirement of a cast metallic root pin with conventional cement method, per tooth	75,93	91,12	98,71	151,86
2.	Gaps of at most 4 missing teeth, surrounded, limited by teeth, per jaw, in case of otherwise unified set of teeth, on condition that there is no free-end-situation (gap situation I). One missing wisdom tooth is not relevant. For teeth next to gaps according to the findings of No. 2, the findings of No. 1.1 to 1.3 can’t be set.
2.1	Gap limited by teeth with one missing tooth, per gap. In case of a finding in the upper jaw at the same time, for the construction of a bridge for the replacement of two missing incisors and for removable dentures, in case of a free-end-situation on both sides, beside the fixed grant according to the finding No. 2.1, a fixed grant according to finding No. 3.1 can be set, fixed in addition.	273,30	327,96	355,29	546,60
2.2	Gap limited by teeth with two missing teeth next to one another, per gap. In case of a finding in the upper jaw at the same time, for the construction of a bridge for the replacement of up to two missing incisors next to one another and for removable dentures, in case of a free-end-situation on both sides, beside the fixed grant according to the finding No. 2.2, a fixed grant according to finding No. 3.1 can be set, fixed in addition.	312,48	374,98	406,22	624,96
2.3	Gap limited by teeth with three missing teeth next to one another, per jaw.	352,26	422,71	457,94	704,52
2.4	Gap between the anterior teeth with four missing teeth next to one another, per jaw.	387,50	465,00	503,75	775,00
2.5	Another gap with one missing tooth limited by teeth directly next to a gap.	152,63	183,16	198,42	305,26
2.6	Not parallel tooth abutment for fixed dentures, per gap.	116,85	140,22	151,91	233,70
2.7	Missing tooth in such a gap, which is limited by teeth in the facing area (15-25 and 34-44), per facing for one replaced tooth, and also for an anchored cap next to the gap in the facing area.	40,80	48,96	53,04	81,60
3.	Gaps limited by teeth, which don’t correspond to the findings of No. 2.1 to 2.5 and No. 4.
3.1	All teeth-limited gaps, which don’t correspond to the findings of No. 2.1 to 2.5 and No. 4, or free-end-situations (gap situation II), per jaw. In case of a finding in the upper jaw at the same time, for the construction of a bridge for the replacement of up to two missing incisors next to one another and for removable dentures, in case of a free-end-situation on both sides, beside the fixed grant according to the finding No. 3.1, a fixed grant according to finding No. 2.1 or 2.2 can be set, fixed in addition.	274,58	329,50	356,95	549,16
3.2	a) Reduced row of teeth on both sides until the canine teeth, b) reduced row of teeth on one side until the canine teeth and interrupted row of teeth contra-lateral in the area of the side teeth until the canine tooth, c) interrupted row of teeth on both sides in the area of the posterior teeth until the canine tooth, with the requirement of a dental anchoring by a telescope-crown, for frontal interrupted row of teeth as well, per canine tooth.	202,21	242,65	262,87	404,42
4.	Remaining number of teeth up to 3 teeth or toothless jaw.
4.1	Remaining number of teeth up to 3 teeth in the upper jaw with the requirement of a tissue-borne cover denture in connection with a dental fixture by telescope crowns or endodontic (o. root) pin cap, per jaw	257,64	309,17	334,93	515,28
4.2	Toothless upper jaw	253,50	304,20	329,55	507,00
4.3	Remaining number of teeth up to 3 teeth in the lower jaw with the requirement of a tissue-borne cover denture in connection with a dental fixture by telescope crowns or endodontic (o. root) pin caps, per jaw.	276,88	332,26	359,94	553,76
4.4	Toothless lower jaw	270,75	324,90	351,98	541,50
4.5	Requirement of a metal base, per jaw	67,93	81,52	88,31	135,86
4.6	Remaining number of teeth up to 3 teeth, per jaw with the requirement of dental fixture by telescope crowns, per anchor tooth.	213,86	256,63	278,02	427,72
4.7	Requirement of the facing of a telescope crown in the facing area (15-25 and 34-44), per anchor tooth.	26,60	31,92	34,58	53,20
4.8	Remaining number of teeth up to 3 teeth, per jaw with the requirement of dental fixture by endodontic (o. root) pin cap, per anchor tooth.	191,64	229,97	249,13	383,28
4.9	Position-connection of the jaws, which is difficult to determine in case of the supply with full dentures and tissue-borne cover dentures (requirement of a bearing device registration), per total finding	47,99	57,59	62,39	95,98
5.	Partially edentulous dental arch after loss of teeth in such cases, when the final medical care is not possible immediately.
5.1	Edentulous dental arch after the loss of up to 4 teeth per jaw, in those cases, when a final medical care is not possible immediately, per jaw.	85,31	102,37	110,90	170,62
5.2	Edentulous dental arch after the loss of 5 to 8 teeth per jaw, in those cases, when a final medical care is not possible immediately, per jaw.	117,50	141,00	152,75	235,00
5.3	Edentulous dental arch after the loss of more than 8 teeth per jaw, in those cases, when a final medical care is not possible immediately, per jaw.	153,80	184,56	199,94	307,60
5.4	Toothless upper and lower jaw, in those cases, when a final medical care is not possible immediately, per jaw.	222,90	267,48	289,77	445,80
6.	Restoring conventional denture which needs to be extended.
6.1	Prosthetically cared set of teeth without a finding-change with removable dentures, which needs to be restored, without the requirement of dental impression (measures in the field of acrylic material), per denture	26,04	31,25	33,85	52,08
6.2	Prosthetically cared set of teeth without a finding-change with removable dentures, which needs to be restored, with the requirement of dental impression (measures in the field of acrylic material), per denture	37,36	44,83	48,57	74,72
6.3	Prosthetically cared set of teeth without a finding-change with removable dentures, which needs to be restored, with measures in the field of cast metal, per denture	57,70	69,24	75,01	115,40
6.4	Prosthetically cared set of teeth without a finding-change with removable dentures, which needs to be restored, with measures in the field of acrylic material, per denture	51,82	62,18	67,37	103,64
6.5	Prosthetically cared set of teeth with a change of the findings, with removable dentures, which needs to be restored, with measures in the field of cast metal, per denture	66,21	79,45	86,07	132,42
6.6	Changed denture-supporting area in case of a preservationable partial denture, per dental prosthesis	49,74	59,69	64,66	99,48
6.7	Changed denture-supporting area in case of a preservationable full denture or a tissue-borne cover denture, per jaw	64,74	77,69	84,16	129,48
6.8	Fixed denture, which can be cemented and needs to be restored, per tooth	8,58	10,30	11,15	17,16
6.9	Facet on a crown or an anchored cap, a bridge span, which needs to be restored, per facet	35,29	42,35	45,88	70,58
6.10	Telescopic coping which needs renewal, per tooth	144,29	173,15	187,58	288,58
7.	Renewal and restoration of implant superstructures, framework
7.1	Superstructure which needs renewal (existing implant in case of a tooth-limited single-tooth gap), per implant-borne crown	114,92	137,90	149,40	229,84
7.2	Superstructure which needs renewal, which goes beyond the finding of No. 7.1, per implant-borne crown, anchored cap or bridge span, four times per jaw at most	71,35	85,62	92,76	142,70
7.3	Superstructure which needs restoration (facet), per facet	35,30	42,36	45,89	70,60
7.4	Fixed denture, which can be cemented and needs restoration, per implant-borne crown or anchored cap, bridge abutment	8,58	10,30	11,15	17,16
7.5	Implant-borne denture construction which needs renewal, per denture construction	261,33	313,60	339,73	522,66
7.6	Denture construction which needs renewal in case of a toothless jaw with atrophy, per implant-borne connector as extra payment to the finding of No. 7.5, four times per jaw at most.	8,58	10,30	11,15	17,16
7.7	Implant-borne denture construction which needs restoration, per denture construction	37,36	44,83	48,57	74,72
8.	Not completed treatment (partial service 2)
8.1	Finding after the preparation of a preservationable tooth, telescope crown or a root pin cap 50 per cent of the fixed grant for the finding of No. 1.1., 1.2, 3.2, 4.6 or 4.8 can be set.
8.2	Finding after the preparation of a preservationable tooth, telescope crown or a root pin cap, if further measures carried out, then 75 per cent of the fixed grant for the finding of No. 1.1., 1.2, 3.2, 4.6 or 4.8 can be set. If applicable the fixed grants for the findings of No. 1.3. or 4.7. can be set.
8.3	Finding after the preparation of the abutment teeth (anchor tooth) of a crown 50 per cent of the fixed grant for the finding of No. 2.1. to 2.5. can be set
8.4	Finding after the preparation of the abutment teeth (anchor tooth) of a crown, if further measures were carried out as well, 75 per cent of the fixed grant for the finding of No. 2.1. to 2.5. can be set. If applicable the fixed grants for the findings of No. 2.7. for abutment teeth or for bridge span can be set.
8.5	Finding after the cast and the determination of the checkbite (bite-taking) for the incorporation of a partial denture, of a cover-denture-prosthesis or a full denture, 50 per cent of the fixed grants for the findings of No. 3.1. or 4.1. to 4.4. can be set.
8.6	Finding after the cast and the determination of the checkbite (bite-taking) for the incorporation of a partial denture, of a cover-denture-prosthesis or a full denture, if further measures were taken, 75 per cent of the fixed grants for the findings of No. 3.1. or 4.1. to 4.4. can be set. If applicable the fixed grants for the findings of No. 4.5. or 4.9. can be set.

[1] During the application No. 4 of the part ‘Generally terms of the fixed grant guidelines’ should be taken into account.
[2] The findings for the 8th partial performance, service assume the estimate of the accompanying partial findings. As they can vary, a prove of the exact amount is not necessary.

Source: KZBV

Diamant-Dent Dental Medical Institute

H-9200 Mosonmagyarovar, Regi Vamhaz ter 11.

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00 800 44556677

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E-mail: info@diamantdent.hu

www.diamantdent.hu