Will my Swiss health insurance refund some of my dental costs?
If you don’t have dental insurance in Switzerland, you know how expensive a dentist’s bill can be. But can some of it be offset by the obligatory health insurance?
Depending on what treatment you need, your dental bill could range from 200 francs (for a tooth filling) to upwards of 10,000 francs for implants.
If you took out dental insurance before you have any consequential work, then some of these costs will be paid for, though — depending on your policy — you will probably have to pay a part out of your own pocket.
Will your obligatory health insurance kick in?
It might, depending on whether your dental problems are closely linked to, or are caused by, a medical condition.
Generally speaking, the basic obligatory insurance (KVG / LaMal) will cover dental treatment if the condition is caused by illness or by medical treatment.
For instance, if will be paid for if:
- It is necessary to treat serious illnesses
- The treatment is for serious, unavoidable infections of the jaw
- The dental problems result from serious medical conditions
Another scenario is if dental treatment is necessary as a result of an accident: if, for example, you fall off your bike and break your teeth, then your obligatory accident insurance will pay.
READ ALSO: How does accident insurance work in Switzerland?
In certain cases, and particularly where children and young people are concerned, dental work could be covered by the Invalidity Insurance (DI), a compulsory social insurance scheme for all persons living in Switzerland.
The DI will, for instance, cover orthodontic treatments in children who have dental problems as a result of birth defects — especially if they are severe enough to pose a risk later in life.
Such treatments are covered up to the age of 20.
Will the KVG / LaMal or DI pay if you are treated abroad?
In very rare cases only.
If, for example, you had an accident in another country, which resulted in dental damage, and are treated there on emergency basis, then you have a chance to get these costs covered.
However, the rules differ depending on where exactly the accident happened.
If the injury and subsequent emergency care occurred in a EU or EFTA country (Norway, Iceland, or Liechtenstein), with which Switzerland has agreements to that effect, then you won’t even have to pay anything for the treatment. All you will have to do is show your Swiss insurance card.
On the other hand, if the injury happened in a 'third' country — like the United States, where the cost of healthcare is insane — then the KVG / LaMal will pay twice the amount that the same treatment would cost in your canton of residence.
So say, if a treatment you received in one of the non-EU/EFTA countries would cost 2,000 francs in your canton, you would get back 4,000 francs, minus whatever co-pay you still owe.
To get the money, however, you will have to send all the necessary paperwork, including proof of payment, to your insurance.
(This, by the way, applies to any kind of medical treatment you receive in a third country, not just to accidents).
This is one scenario under which you can see your foreign dental costs refunded.
If, however, you choose to go abroad for dental treatment because it is cheaper there, then the Swiss insurance, or the DI, won’t pay for anything.
Not only that, but you will also not be able to claim the cost of your dental treatment from your Swiss tax bill — an option available to all of Switzerland’s residents.
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Depending on what treatment you need, your dental bill could range from 200 francs (for a tooth filling) to upwards of 10,000 francs for implants.
If you took out dental insurance before you have any consequential work, then some of these costs will be paid for, though — depending on your policy — you will probably have to pay a part out of your own pocket.
Will your obligatory health insurance kick in?
It might, depending on whether your dental problems are closely linked to, or are caused by, a medical condition.
Generally speaking, the basic obligatory insurance (KVG / LaMal) will cover dental treatment if the condition is caused by illness or by medical treatment.
For instance, if will be paid for if:
- It is necessary to treat serious illnesses
- The treatment is for serious, unavoidable infections of the jaw
- The dental problems result from serious medical conditions
Another scenario is if dental treatment is necessary as a result of an accident: if, for example, you fall off your bike and break your teeth, then your obligatory accident insurance will pay.
READ ALSO: How does accident insurance work in Switzerland?
In certain cases, and particularly where children and young people are concerned, dental work could be covered by the Invalidity Insurance (DI), a compulsory social insurance scheme for all persons living in Switzerland.
The DI will, for instance, cover orthodontic treatments in children who have dental problems as a result of birth defects — especially if they are severe enough to pose a risk later in life.
Such treatments are covered up to the age of 20.
Will the KVG / LaMal or DI pay if you are treated abroad?
In very rare cases only.
If, for example, you had an accident in another country, which resulted in dental damage, and are treated there on emergency basis, then you have a chance to get these costs covered.
However, the rules differ depending on where exactly the accident happened.
If the injury and subsequent emergency care occurred in a EU or EFTA country (Norway, Iceland, or Liechtenstein), with which Switzerland has agreements to that effect, then you won’t even have to pay anything for the treatment. All you will have to do is show your Swiss insurance card.
On the other hand, if the injury happened in a 'third' country — like the United States, where the cost of healthcare is insane — then the KVG / LaMal will pay twice the amount that the same treatment would cost in your canton of residence.
So say, if a treatment you received in one of the non-EU/EFTA countries would cost 2,000 francs in your canton, you would get back 4,000 francs, minus whatever co-pay you still owe.
To get the money, however, you will have to send all the necessary paperwork, including proof of payment, to your insurance.
(This, by the way, applies to any kind of medical treatment you receive in a third country, not just to accidents).
This is one scenario under which you can see your foreign dental costs refunded.
If, however, you choose to go abroad for dental treatment because it is cheaper there, then the Swiss insurance, or the DI, won’t pay for anything.
Not only that, but you will also not be able to claim the cost of your dental treatment from your Swiss tax bill — an option available to all of Switzerland’s residents.
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