What is my Dental Credit Balance?

The amount is indicated on your latest benefits advice. This information cannot be given to you over the telephone: the amount depends on any claims being processed, so the Reimbursement Unit has first to check before telling you. The amount changes at the start of each year because you can accumulate credits only for the last two years (today, for example, your balance for 2012 + your balance for 2013). The dental credit of each member is CHF 2,500 per year cumulative over 2 years, therefore a total maximum of CHF 5,000 except for new members during the first year of affiliation for whom the calculation is made in prorata to the number of months of affiliation. Dental treatment is reimbursed at 80% up to the dental credits available at the time when the treatment has been done.

It is imperative to note that expenses will always erode the credit of the year in which the expenses were encountered first. Should this be insufficient then any carried over credit from the previous year will be further eroded.  This basically means that if you have expenses of CHF 2,500 or more any given year you will not carry over anything to the next year.

For Example:

2011 credit carried over to the next year CHF 2,000

2012 starting credit CHF 2,500 + CHF 2,000 carried over for a total of CHF 4,500

In 2012 dental expenses totalling CHF 3,500.

CHF 2,500 are offset against 2012 credit and then the remaining CHF 1,000 from the 2011 carry over. Although total expenditure is CHF 3,500 there will be no carry over to 2013 because the 2012 credit was entirely used up and the 2011 balance cannot be brought forward another year past 2012.

 

It is not necessary to get our Medical Adviser’s prior authorization for dental and/or orthodontic treatment.

Attention: for temporary staff with contracts of less than 3 months, dental treatment is not covered except for emergency treatments approved by the Medical Adviser at 80% up to a maximum of CHF 500.