Anders has lost two teeth. The dentist explains that he has lost these teeth due to periodontitis. Reimbursement can only be given for treating one of the teeth. For periodontitis, reimbursement is not available for teeth in the back of the mouth. Anders thinks the treatment will be too expensive, even if part of the cost for one of the teeth is covered. He has heard that he can get this treatment in another EU/EEA country, and decides to get it done abroad. He knows that the treatment must be documented to get a reimbursement from Helfo.
Dental treatment in the EU/EEA
In Norway, as a rule, you are liable for your own dental costs. However, there are some exceptions, and these exceptions also apply within the EU/EEA. Go through all the steps in this guide to understand your rights and what you need to do. The claim form is included in Step 9.
Illustration: Morten Rakke / Helfo
1
Reimbursement for certain conditions
Only certain, specific conditions/cases are eligible for reimbursement for dental treatment received outside Norway. There is also a limit to the amount you can be reimbursed.
In order to be eligible for this scheme you must be a member of the National Insurance Scheme. In many cases, the scheme also applies to family members. You are not entitled to a subsidy from Norway for treatment in an EU/EEA country you are regarded as ordinarily resident in. Click here for important information on who qualifies for this scheme.
There are 15 conditions that may be eligible for reimbursement:
1. Rare medical conditions
2. Cleft lip-jaw-palate
3. Tumours in the oral cavity, adjacent tissue or in the head region in general
4. Treatment to prevent infection associated with certain medical conditions
5. Diseases and abnormalities in the mouth and jaw (dental and maxillofacial procedures)
6a. Periodontitis (gum disease)
6b. Prosthetic rehabilitation for severe marginal periodontitis (tooth replacement as a result of gum disease)
7. Tooth developmental disorders (congenital conditions)
8. Bite abnormalities (dental braces/orthodontic treatment)
9. Pathological loss of tooth substance due to attrition/erosion (teeth grinding and acid damage)
10. Hyposalivation (dry mouth)
11. Allergic reactions to tooth restoration materials (in oral cavity
or on skin)
12. Tooth damage related to a recognised occupational injury
13a. Extensive dental injury resulting from an accident
13b. Traumatic dental injury in persons suffering from medical conditions associated with risk of fall injuries
14. Severely reduced capacity for self-care due to permanent illness or permanent disability (the severely reduced capacity for self-care must have lasted for more than one year and have resulted in poorer dental health)
15. Full or partial loss of teeth, with no original teeth in the lower jaw (and unable to use dentures).
Even if your condition comes under one of these listed conditions, there is no guarantee that you will be entitled to reimbursement of any treatment you have received. This is because certain requirements have to be met.
Your dentist in Norway will be able to provide more information about the reimbursement rules. You can also read about national insurance benefits for coverage of dental treatment expenses in Norwegian Directorate of Health's circular (in Norwegian).
You must ensure that Helfo receives the required documentation so that we have a fair basis for deciding if you meet the criteria for reimbursement.
Helfo cannot grant a reimbursement if your claim is missing documentation. See Step 7 for a list of what you need to enclose with your claim.
If you require orthodontic treatment, you must have a referral from a dentist or dental hygienist practising in Norway. You must bring the referral with you from Norway. In other words, a referral from a Norwegian dentist abroad is not sufficient.
Expenses for necessary orthodontic treatment (dental braces) abroad are covered according to the same rates as in Norway.
Example
2
Reimbursement for certain groups
Certain groups of people are entitled to necessary dental care within the public dental health service in Norway. Some of these groups of people may be able to transfer their right to treatment to other EU/EEA countries.
These groups are
- children and young people under age 18
- people with mental disabilities, living in or outside of institutions
- senior citizens with chronic illness or disabilities in institutional care or receiving home nursing
- young people who turn 19 or 20 in the year of treatment (user fee of 25 per cent of the fixed rates in Norway)
Other groups which the county authority has granted priority cannot transfer their entitlement to treatment to other EU/EEA countries.
Example
Because Anders is not in any of these groups, he is not eligible for reimbursement under this scheme.
3
You must locate a treatment provider yourself
You need to find a dentist or dental hygienist in another EU/EEA country. If parts of your dental costs are covered by Helfo, it is normal for a dentist to provide the treatment. In certain cases, an authorised dental hygienist may treat periodontitis (gum disease).
The treatment provider must have valid public authorisation in the country in question. This means that the treatment provider must have a licence to practise as a dentist or dental hygienist in the country where the treatment is provided. Responsibility for documenting this rests with you alone.
For example, treatment providers in Spain must
- have public authorization in Spain
- be a member of the Council of Dentists
You must check whether there is a condition that the treatment is provided by a specialist. In this case, you must check whether the person in question has the necessary specialisation for equivalent treatment in Norway.
Note that dentists in the EEA often have different specialist expertise than dentists in Norway. In that case, the specialist training must correspond to the Norwegian specialist training. Responsibility for documenting this rests with you alone.
Are you planning to receive health care in the UK? Click here for information about the consequences of Brexit (in Norwegian).
Example
Anders finds a dental clinic abroad. He investigates whether the treatment he wants will be provided by dentists or dental hygienists who have valid public authorisation. He knows that he needs documentation back in Norway that each treatment provider he visits is entitled to practise in the country in question.
4
Requirements in the case of prosthetic implants
Special requirements apply to treatment providers in the case of prosthetic implants.
In order for prosthodontic treatment costs to be covered, both the dentist performing the surgery and the dentist making the prosthesis must have specialist training in their fields.
If either of the dentists fails to meet the requirements, none of your expenses can be covered.
Example
In order for the costs of periodontitis treatment to be covered, Anders must visit a specialist. He must also check whether the person in question has the necessary specialisation for equivalent treatment in Norway. Anders must verify the following: a) That the dentist has prepared a treatment plan. The plan must show which teeth are to be treated/replaced and why. b) That both the surgical and prosthetic work is carried out by dentists with the correct specialisation.
5
The risks of undergoing treatment abroad
The risk of being infected by bacteria that are resistant to antibiotics, such as «staph» bacteria, called MRSA, is higher if you have treatment outside Norway.
The first aspect to consider is that the treatment you receive abroad must be equivalent to what you would receive in Norway, and may need to be followed up by a dentist in Norway. In some cases, there may be slight differences that make it difficult to provide follow-up care in Norway.
In the event of acute complications, it may in some cases also be difficult for the dentist in Norway to provide follow-up care for treatment provided abroad. This is because the procedure and/or the devices (e.g. implants) used may be of a different type than those used in Norway.
Infections
Antibiotic-resistant bacteria (in Norwegian), such as the «Staph» bacteria called MRSA (meticillin-resistant Staphylococcus aureus), pose an increasing health risk in many countries. You will need to bear in mind that the risk of being infected with such bacteria is higher if you travel outside Norway for treatment.
If you have received dental care or extensive outpatient care or have been hospitalised outside the Nordic region within the last 12 months, your regular GP will have to test you for strains of antibiotic-resistant bacteria before you can receive treatment from a hospital in Norway.
If you have any questions about this, please consult your GP.
Patient injury compensation
All forms of medical treatment carry a risk. If anything goes wrong during the medical care you receive in Norway, you can apply for compensation from the Norwegian System of Patient Injury Compensation (NPE).
If the medical care was provided in one of the Nordic countries, you can apply for compensation through the national systems for patient injury compensation in the individual countries. The NPE can advise you on how to proceed.
If you have suffered an injury as a result of treatment abroad, the rules in the country of treatment regarding compensation prevail, and you are personally responsible for claiming compensation.
If the country has a dedicated body for patient injury compensation, you will need to contact this body yourself. The National Contact Point in the country of treatment (in Norwegian) can assist you in contacting the right body. Alternatively, you may need to claim compensation for injury sustained as a result of medical care directly from the place of treatment.
The Norwegian Patient Injury Act only applies to hospitals and doctors abroad if the Norwegian health service has concluded a prior agreement with the place of treatment in a contract for procurement of services. An example of this cover would be when patients are sent abroad as a result of a maximum waiting time guarantee.
Example
Anders is aware of the fact that the risk of being infected by bacteria that are resistant to antibiotics is higher if he has treatment outside Norway.
6
The dentist must complete a form for you to send in
You must bring a special form for the dentist before you start the treatment and ask the dentist who will be treating you to complete and sign the form. You must enclose the form from the dentist with your claim form.
The form to be completed by the dentist/orthodontist after each treatment procedure is called
For the initial assessment for orthodontic work, you must also ensure that the form
is completed by the orthodontist who treats you outside Norway.
You must also have documentation of which treatment has been performed. The orthodontist does this by completing the following form:
These forms must be enclosed with your claim form together with your X-rays and treatment plan.
Please note that the treating orthodontist must fill in a new description of treatment (form 05-24.15) for each visit. These must be sent to Helfo within 6 months of each individual treatment date together with itemised receipts.
Example
Anders checks with the dentist who has provided the treatment that the claim form for treatment providers has been completed and signed. He also ensures that X-rays taken before the treatment began and itemised receipts showing payment of the treatment are included.
7
Limited reimbursement of travel expenses
You will not be reimbursed for more than you would have received if the treatment had been performed in Norway.
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.
Claims for travel expenses reimbursements must be sent to Helfo on this claim 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).
Example
Anders lives in Fåvang. His nearest place of treatment in Norway would be Lillehammer. Although Anders is going abroad, he will only be entitled to expenses for the journey Fåvang-Lillehammer-Fåvang at a standard rate per kilometre. He takes care to keep all his travel documents.
8
Don't forget the documentation!
Study this guide carefully so that you know exactly what documentation you need to enclose with your application.
In order for Helfo to consider the claim and reach a decision, the documentation must be comprehensible. This means that all documentation must initially be in Norwegian, Danish, Swedish or English. You should therefore try to get the documentation issued in one of these languages. If the documents are in another language, Helfo can, if necessary, ask you to have them translated. You must pay for the translation yourself. If you send in a translated document, you must also send in the original.
You must enclose the following with your application:
- the form which the dental treatment provider has completed (see Step 6)
- documentation that all treatment providers have valid authorisation
- documentation to prove that each treatment provider is a licensed specialist (for implants and implant prosthetics or orthodontic treatment)
- the necessary X-ray images taken before the treatment you are claiming a reimbursement for
- dental records of your condition, diagnostic tests and assessments and any treatment provided before the treatment you are claiming a reimbursement for
- original receipts for all expenses
- documentation that the expenses have been paid
For the following conditions/cases, you are required to provide us with supplementary documentation:
1. Rare medical conditions
- a medical statement confirming your diagnosis
2. Cleft lip-jaw-palate
- a referral letter from a centralised cleft lip, jaw and palate team (LKG team)
3. Tumours in the oral cavity, adjacent tissue or in the head region in general
- no requirement for supplementary documentation
4. Treatment to prevent infection associated with certain medical conditions
- a medical statement confirming your diagnosis
5. Diseases and abnormalities in the mouth and jaw (dental and maxillofacial procedures)
- no requirement for supplementary documentation
6a. Periodontitis (gum disease)
- no requirement for supplementary documentation
6b. Prosthetic rehabilitation for severe marginal periodontitis (tooth replacement as a result of gum disease)
- if any teeth were lost before treatment starts: a printout of your dental records from the dentist, stating when and why
7. Tooth developmental disorders (congenital conditions)
- clinical photographs of damaged teeth, in addition to X-rays taken before treatment started
- dental records or documentation from previous dentist in the case of tooth agenesis (failure of teeth to develop)
8. Bite abnormalities (dental braces/orthodontic treatment)
- referral from Norwegian dentist/orthodontist
- the forms completed by the orthodontist abroad (see Step 5)
- clinical photographs of damaged teeth, in addition to X-rays taken before treatment started
9. Pathological loss of tooth substance due to attrition/erosion (severe teeth grinding and acid damage)
- models or clinical photographs of damaged teeth, in addition to X-rays taken before treatment started
- printout of dental records from dentist confirming that teeth were lost/extracted before the treatment started
10: Hyposalivation (dry mouth)
- printout of dental records showing the results of saliva tests from the last 3-4 years from previous dentist(s)
- a medical statement confirming your diagnosis and any medication you take
11: Allergic reactions to tooth restoration materials (in oral cavity or on skin)
- clinical photographs, in addition to X-rays taken before treatment started
- statement from a dermatologist
12: Tooth damage related to a recognised occupational injury
- NAV decision letter recognising the occupational injury
13a: Extensive dental injury resulting from an accident
- the dentist's description of the injury shortly after the time of the injury
13b. Traumatic dental injury in persons suffering from medical conditions associated with risk of fall injuries
- the dentist's description of the injury, how it arose and any initial treatment
14: Severely reduced capacity for self-care due to permanent illness or permanent disability (the severely reduced capacity for self-care must have lasted for more than one year and have resulted in poorer dental health)
- medical statement on inability to maintain own dental health
15: Full or partial loss of teeth, with no original teeth in the lower jaw (and unable to use dentures)
- no requirement for supplementary documentation
Example
Anders makes sure he gets copies of specialist approvals and authorisations. He must also remember to submit documentation for teeth that were missing before he went abroad for dental treatment.
9
Submit your application
When you have received the treatment, you can apply to Helfo for a refund. Applications must be submitted within 6 months of each individual treatment date.
For details about documentation requirements, see "Don't forget the documentation".
Applications must be submitted within 6 months of each individual treatment date.
Paper form
If you are unable to use our digital form, you can complete the following form instead:
Send the application form together with documentation to: Helfo, Postboks 2415, 3104 Tønsberg.
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.
Example
Anders fills out the application form and sends this together with all the relevant documentation to Helfo within six months.
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Last updated Sunday, January 1, 2023