How to pave the ground for a refund by your health-carrier
Saving time and trouble:
Have your local dentist draft a Treatment- & Cost Estimate (TCE) in writing and mail that to your Hungarian dental clinic of choice, who will respond with an - obviously - much more reasonable TCE-counter offer. Once furnished with those two documents now do contact your local carrier who will evaluate the need for treatment and eventually approve it. Now your future claim for refund is based on solid ground.
Brace yourself for a surprise when it comes to the difference in cost as the following example taken from real life might demonstrate:
| Treatment- & Cost Estimate at home: |
€ 24.016,24 | (Original: HKP_Inland.pdf) |
| Counter-Offer Hungary 1: |
€ 11.800,00 | (Original: HKP_HU_1.pdf) |
| Counter-Offer Hungary 2: |
€ 15.160,00 | (Original: HKP_HU_2.pdf) |
This particular patient eventually opted for option # 2 also offering much superior quality while still saving - when compared to the run-of-the-mill estimate at home - in excess of
€ 8.850,00!
Please Note!
Basis for computation of acceptable cost, as of January 1st 2005, are such cost a health care carrier would cover for treatment locally; dubbed CommonCareCost (CommonCareCost = the cost acceptable locally for treatment according to medical findings classified needed common treatment. In other words: With missing teeth not the implants you might desire will constitute grounds for computation but the minimum possible type of treatment, which - in this case - would most likely by a partial prosthesis).
Refund by local carrier shall be at least 50% of the local CommonCareCost.
But: If you turn for treatment to another member-state of the EC, i.e. the much cheaper Hungary, the law requires that any discounts thus enjoyed shall have no effect at the amount of refund!
Conclusion: If the calculation of cost associated with your local CommonCareCost would come to € 500.00 your local health carrier will have to at least refund € 250.00.
It consequently is completely up to your own discretion what kind of dental treatment you want to have, since all that matters is treatment has been completed - retaining your just claim in any case.
Summarizing this with two simple examples:
| 1.) Total Prosthesis: |
|
| CommonCareCost locally: |
€ 890,00 |
| minus 50% carrier allowance: |
€ 445,00 |
| Out of your pocket: |
€ 445,00 |
| Actual Cost in Hungary: |
€ 450,00 |
| minus 50% carrier allowance (home): |
€ 445,00 |
| Actual cost of treatment to you: |
€ 5,00 |
| 2.) 1 Crown (visible frontal area of face): | |
| CommonCareCost locally; Synthetic-Crown: |
€ 590,00 |
| minus 50% carrier allowance: |
€ 295,00 |
| Out of your pocket: |
€ 295,00 |
| Actual Cost Hungary; Zirconoxide-Crown!: |
€ 350,00 |
| minus50% carrier allowance: |
€ 295,00 |
|
Actual cost of treatment to you: |
€ 55,00 |
You've just saved € 240.00 of your very own cash - PLUS you benefit from not just the „plastic-version" but the much better looking and way more durable one made from Zircon-Oxide!
Remark: To proceed as suggested above neither is illegal nor immoral - this simply is money due to you by law.
You've every reason to be smart and collect what's due to you.