Dental treatment in the EU/EEA

This applies to

• priority groups of individuals (see step 2)
• individuals with certain conditions/cases (see step 3)

To be entitled to reimbursement, you must normally be a member of the Norwegian National Insurance Scheme.

If Helfo considers you to be resident in another EU/EEA country, you will not be able to obtain reimbursement from Helfo for dental treatment there.

Click here for important information about who can be reimbursed for expenses for planned treatment in the EU/EEA.

If you are entitled to reimbursement of expenses for essential dental care in the public dental health service in Norway, you may be entitled to reimbursement for expenses for similar treatment in another EU/EEA country.

The priority groups are

• children and adolescents under 18 years of age
• individuals with a development disability whether or not they are resident in an institution
• elderly long-term sick and disabled persons in an institution or being cared for at home
• young adults who reach the age of 19, 20, 21, 22, 23 or 24 in the year of treatment (user fee of 25 percent of the standard Norwegian rate)
• persons who, due to substance dependence, receive certain services, see tannhelsetjenesteloven § 1-3 (lovdata.no)

Other groups that the county council has decided to prioritise cannot take with them the right to reimbursement of expenses for treatment to other EU/EEA countries.  

Even if your condition falls under one of the points below, you may not be entitled to reimbursement for the treatment you have received. This is because there are various conditions that must be met.

15 conditions/cases may entitle you to benefits:

• Benefit point 1 Rare medical conditions
• Benefit point 2 Cleft lip and palate (CLP)
• Benefit point 3 Tumour in the oral cavity, adjacent tissue or the head region generally
• Benefit point 4 Dental treatment for infection prevention in connection with special medical conditions
• Benefit point 5 Diseases and anomalies of the mouth and jaw (dental and maxillofacial surgery)
• Benefit point 6a Periodontitis (gum disease)
• Benefit point 6b Rehabilitation for tooth loss due to severe marginal periodontitis 
• Benefit point 7 Tooth development disorders (congenital conditions)
• Benefit point 8 Bite anomalies (braces/orthodontics)
• Benefit point 9 Pathological loss of tooth surface through attrition/erosion (severe teeth grinding and acid damage)
• Benefit point 10 Hyposalivation (dry mouth)
• Benefit point 11 Allergic reactions to dental restoration materials (in the oral cavity or on the skin)
• Benefit point 12 Dental injuries linked to an approved occupational injury
• Benefit point 13a Extensive dental injury linked to an accident
• Benefit point 13b Traumatic dental injuries in users suffering from an illness that could cause fall injuries
• Benefit point 14 Severely impaired ability to care for oneself in persons with a permanent illness or disability (the severe impairment must have lasted for at least one year and have affected dental health)
• Benefit point 15 Complete or partial loss of teeth, with no teeth in the lower jaw (and unable to use a removable denture)

If you are wondering whether you have one of these conditions/cases, you should contact your dentist or dental hygienist in Norway to find out more.

You can also read the Norwegian Directorate of Health's circular on benefits for dental treatment (in Norwegian – helsedirektoratet.no).

The requirements regarding dentists/dental hygienists may vary between the different EU/EEA countries. You must ensure that the dentist/dental hygienist you will be treated by both has valid official authorisation and is able to practise legally in the country concerned. When you apply to Helfo for reimbursement, you may be asked to provide documentary proof that the dentist/dental hygienist meets the requirements.

Requirements relating to specialist expertise

For some treatments, it is a condition in Norway that the dentist has a relevant specialisation. If you intend to have such treatment abroad, the dentist who will treat you must have a corresponding specialisation in order for you to be entitled to reimbursement from Helfo. You should check in advance what specialist requirements apply in Norway for the treatment you are to have. You must also check whether the dentist/dentists abroad have a similar specialisation.

You should note that dentists in the EEA often have different specialist expertise from dentists in Norway. The specialist training must then correspond to the Norwegian specialist training. It is your responsibility to document this.

Orthodontics

You can only get reimbursement for orthodontic treatment if an orthodontist has performed the treatment. 

CT/MRI

You can only be reimbursed for expenses for jaw and facial radiological examinations using CT/MRI if the examinations were performed by a specialist in jaw and facial radiology.

Implant anchored prosthetics

With implant anchored prosthetics, your tooth will be replaced with an implant (an artificial tooth root) to which a denture is attached.

You can only obtain reimbursement for this if both the dentist who inserts the dental implant and the dentist who inserts the prosthesis possess the necessary expertise in their field. If one of these dentists does not meet the requirement, you will not be reimbursed for any of your expenses.

The dentist who inserts the implant must have specialist expertise in one of the following fields:

• oral surgery and medicine
• maxillofacial surgery
• periodontics

The dentist who attaches the prosthesis must have specialist expertise in oral prosthetics or further education in implant prosthetics.

Follow-up and complications

In principle, the treatment you receive abroad should be similar to what you would have received in Norway, and it can be followed up by dentists here. In some cases, there will be minor differences that will make it difficult to follow up the treatment in Norway. You may need to return to the country in which you were treated for follow-up.

In the event of acute complications, it may also be difficult in some cases for dentists in Norway to follow up treatment that has been provided in another country. This is because the method and/or implants used, for example, may differ from what is used in Norway.

Infections

Antibiotic-resistant bacteria, such as Staphylococcus aureus aureus known as MRSA (methicillin-resistant Staphylococcus aureus), are a growing problem in many countries. You must be aware that the risk of being infected by such bacteria is greater if you leave Norway in order to have treatment.

If you have had dental treatment or extensive outpatient treatment or been admitted to hospital outside the Nordic region within the last 12 months, your GP must test you for bacteria that are resistant to antibiotics before you can be treated at a hospital in Norway.

Contact your GP if you have any further questions about this.

Patient injury compensation

All forms of medical treatment involve risks. If something goes wrong during your treatment in Norway, you can apply for compensation from the Norwegian System of Patient Injury Compensation (in Norwegian).

If the treatment was provided in one of the Nordic countries, you can apply for compensation through this system. The system will be able to provide you with guidance on what you need to do.

If you have sustained an injury as a result of treatment abroad, the rules on compensation in the country of treatment will apply, and you must submit a claim for compensation yourself.

If there is a separate patient injury compensation scheme in the country of treatment, you must contact this scheme yourself. You can get help from the National contact point in the country of treatment to get in touch with the right authority. Alternatively, you may have to submit a claim for compensation after suffering an injury linked to treatment directly to the healthcare provider.

The Norwegian Patient Injury Act only covers foreign hospitals and doctors if the public sector has entered into an agreement with the treatment provider in advance through an agreement on the purchase of services. One example is when patients are sent abroad as a result of a waiting list guarantee.

You must bring a separate form with you at the start of treatment and ask the dentist/dental hygienist who is treating you to fill it in and sign it. You must attach this form to your application.

For all treatment other than orthodontics, the practitioner must complete this form after each treatment:

Forms relating to orthodontic treatment

Your orthodontist must complete a price form for each treatment. In the case of an initial assessment, your orthodontist should also complete a diagnosis form.

Price form

Diagnostic form:

You must make sure that Helfo receives the necessary documentation, so that we have the information we need to assess whether or not the conditions for reimbursement are met.

In order for Helfo to reach a decision concerning an application, we must be able to understand the documents. This basically means that they must be in Norwegian, Danish, Swedish or English. You should therefore try to get the documents issued in one of these languages. If the documents are in another language, Helfo may ask you to have them translated. You will have to pay for the translation yourself. If you submit a translation, you must also submit the original.

You must always enclose the following with your application:

• the form completed by the treating dentist (see step 6)
• necessary X-rays taken before the treatment for which you are seeking reimbursement
• treatment summary/records documenting your condition and the treatment provided
• itemised invoice
• confirmation of payment

Additional documentation is required for certain conditions/cases. You can read more about these conditions/cases in “Circular to the National Insurance Act, Section 5-6, Section 5-6 a and Section 5-25 – examination and treatment by a dentist and dental hygienist for illness and injury” (in Norwegian – helsedirektoratet.no). 

Benefit point 1 Rare medical conditions

• medical certificate confirming your diagnosis
• if your diagnosis is on the B list in the list of rare medical conditions, the dentist/dental hygienist must confirm that the diagnosis in your particular case results in a greater need for dental treatment
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 2 Cleft lip and palate (CLP)

• referral from a centralised CLP team

Benefit point 3 Tumours in the oral cavity, adjacent tissue or the head region in general

• records/documentation confirming the diagnosis, showing how the disease/diagnosis has directly affected your oral and dental health
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 4 Dental treatment for infection prevention in connection with special medical conditions

• A medical certificate confirming your diagnosis and justifying the need for infection-preventing dental treatment – the medical certificate must be dated before the start of the treatment
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 5 Diseases and anomalies of the mouth and jaw (dental and maxillofacial surgery)

• Make sure the documentation from your treating dentist describes the surgical and/or oral medical treatment you have received

Benefit point 6a Periodontitis (gum disease)

• If not specified on the invoice: information about the time spent and a statement of the cleaning that has been performed

Benefit point 6b Rehabilitation for tooth loss due to severe marginal periodontitis

• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 7 Tooth development disorders (congenital conditions)

• clinical photographs of your teeth taken before the treatment started, in addition to X-rays
• in the case of agenesis (absence of one or more teeth): medical records or documentation from previous dentist
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 8 Bite anomalies (braces/orthodontics)

• referral from a Norwegian dentist or dental hygienist
• the forms completed by the treating orthodontist abroad (see step 5)
• clinical photographs showing tooth position and bite, taken before treatment started, in addition to X-rays

Benefit point 9 Pathological loss of tooth surface by attrition/erosion (severe teeth grinding and acid damage)

• clinical photographs showing the condition of the teeth before treatment, alternatively images of plaster models or digital imprints, in addition to X-rays
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 10 Hyposalivation (dry mouth)

• documentation confirming the diagnosis and showing how dry mouth has affected your dental health over time
• if you are receiving dental treatment to replace lost teeth: documentation showing when and why your teeth were lost/extracted

Benefit point 11 Allergic reactions to dental restoration material (in the oral cavity or on the skin)

• clinical photographs showing reaction/damage, taken before treatment started
• statement from dermatologist

Benefit point 12 Dental injury linked to an approved occupational injury

• decision concerning an approved occupational injury from NAV
• the documentation from the treating dentist must show a causal link between an approved occupational injury and the dental treatment concerned

Benefit point 13a Extensive dental injury linked to an accident

• the dentist's description of the injury soon after the time of injury
• medical records showing dental status before the injury
• clinical photographs showing extent of injury

Benefit point 13b Traumatic dental injuries in users suffering from illness that could cause fall injuries

• the dentist's description of the injury, how it occurred and what has been done
• medical certificate confirming diagnosis/illness

Benefit point 14 Severely impaired ability to care for oneself in persons with a permanent illness or disability (the severe impairment must have lasted for at least one year and have caused reduced dental health)

• medical certificate of inability to care for one's own dental health
• statement from the dentist/dental hygienist describing how dental health is affected

Benefit point 15

• documentation from a dentist that a removable prosthesis has been attempted, with a description of why a fixed prosthesis is necessary

You may be granted reimbursement of your travel expenses, corresponding to what you would have received in Norway. You are only entitled to have your travel expenses covered if you are granted reimbursement of your dental treatment.

In Norway, the main rule is that your travel expenses are reimbursed at a standard rate per kilometre regardless of which means of transport you use. You must travel to the geographically closest location at which the healthcare can be provided. In order to be reimbursable, your journey from home must be longer than ten kilometres each way and cost more than the local minimum fare by scheduled public transport.

Eligible travel expenses can be claimed using this form:

(The form is in Norwegian, but click here for an English guide with instructions for filling out the form “Reiseregningsskjema".)

Send the claim form with the other documentation. If your application for coverage of expenses from Helfo is granted, Helfo will forward your travel expenses claim to the Norwegian regional health authorities' patient-travel service (Pasientreiser). 

You must send the application form and documentation to Helfo within 6 months of each treatment date. If you have not settled on the spot but received an invoice afterwards, we calculate the deadline from the invoice date instead of the treatment date. In this context, invoice means the first payment request issued by your treatment provider.

For details about documentation requirements, see "Don't forget the documentation".

Helfo's case-processing time is up to 12 weeks. If necessary documentation is not included with the application, the processing time will be longer.

Paper form

If you are unable to use our digital form, you can fill in the following form instead and send it with the necessary documentation to Helfo, Postboks 2415, 3104 Tønsberg:

Parents/guardians must also have power of attorney from children over the age of 18. In the case of health information, you must have power of attorney from children over the age of 16. This is because the legal age of majority for healthcare is 16.

Fill in the power of attorney form and send it to Helfo as an attachment to the digital form, or send it by post to Helfo, Postboks 2415, 3104 Tønsberg. Remember to enclose a copy of valid identification for the person granting the power of attorney.

This also applies if the healthcare is received in another EU/EEA country.

The user fee payable will be calculated during processing of your application for reimbursement for treatment abroad. This user fee will be entered in the user-fee registry and will form the basis for a healthcare exemption card. If you already hold an exemption card, the user fee will be paid to you together with the reimbursement.

Once you have been issued with an exemption card by Helfo, you will no longer have to pay user fees for healthcare covered by the exemption card scheme. The exemption card is valid in Norway. In other EU/EEA countries you must pay for treatment out of pocket.

Read more about maximum user fees and which types of healthcare are comprised by the exemption card system.