Chapter 1. Introductory provisions
The law's scope and purpose
section 1 of this Act contains provisions on the compensation of
caregivers for performed dentistry (State dental care).
State dental care is provided in the form of General
Dental contributions, particularly dental contributions and
dental health care. Law (2011:1189).
2 for the purposes of this Act, section
1. dental care: measures to prevent, investigate and treat
diseases and lesions in the oral cavity,
2. health care provider ' means the natural or legal person who professionally
engaged in dental care.
section 3 of the insurance fund leaving State dental care for
1. preventive dental care, and
2. dental treatment that the patient needs and aimed at
achieve
-freedom from pain and disease,
-ability to eat, Chew and talk without major obstacles, or
-an appearance acceptable results.
Dental care shall aim to preserve as far as possible in the mouth
tissues. The quality and durability of the treatment should be weighed against the
costs.
Government, or the Government authority determines,
Announces rules on what dental measures that can
be eligible for compensation under this Act and under what
conditions may be reimbursed for these measures
(eligible dental procedures).
General provisions concerning the right of State dental care
section 4 of the State dental care may be provided for dental measures
completed from the year in which the patient turns 20 years old.
Provisions on free dental care for children and young people
and with the year in which they turn 19 years of age, see 7 § 1 and § 15 a
first subparagraph dental Act (1985:125).
paragraph 5 of the State dental care may be provided if the patient, when
Dental operation begins;
1. are insured for residence-based benefits under 4
and Chapter 5. the social security code, or
2. without being a resident here are entitled to benefits
following a decision of the European Parliament and Council Regulation (EC) no
883/2004 of 29 april 2004 on the coordination of social
security systems. Law (2010:1322).
section 6 of the State dental care support shall not be granted for such dental care
referred to in the sixth paragraph 15 a of the dental Act (1985:125).
Law (2010:251).
Chapter 2. General and particular dental contributions and
dental health care
General dental premiums
§ 1 General Dental grants may be used for payment of
eligible dental measures during a period
of a maximum of two years from 1 July each year,
If the patient is on that date fulfil the requirements in Chapter 1. 5 § 1
or 2.
Each submission may be used for payment at only one
opportunity. Law (2011:1189).
Especially dental premiums
1 a of the Particular Dental grants may be used for payment
by reimbursable preventive dental measures
during the two periods each of not more than six months each year,
counting from 1 January and 1 July,
If the patient
1. that date fulfil the requirements in Chapter 1. 5 § 1 or 2,
and
2. when dental task starts with a disease or
disability that causes risk for impaired
dental health.
The Government or the authority, as the Government determines
Announces rules those diseases and
disabilities referred to in the first subparagraph of paragraph 2.
Law (2011:1189).
Common provisions on dental premiums
2 § dental contribution may also be used for payment in accordance with
a contract for the subscription agreement means that dental care, if
the health care provider for a period of three years at a fixed price
to perform the dental patient needs in the form of
1. surveys and investigations;
2. health promotion,
3. treatment of sickness and pain, as well as
4. restorative care.
The agreement may also cover other dental care than is said in
the first paragraph. Law (2011:1189).
section 3 of the Government Announces rules on dental benefits
size. Law (2011:1189).
Dental health care
4 § For eligible dental measures
completed during the replacement period of one year, provided
dental health care with a certain percentage of the patient's total
costs, insofar as these exceed the amount
determined in accordance with paragraph 6 of the 1.
The cost is calculated on the basis of the reference rates for
eligible dental operations. The cost of a
action taken must not, however, be estimated higher than an amount
the corresponding healthcare provider's price for the operation for the current
the patient.
Benefit period referred to in the first subparagraph begins when a
the first eligible action is completed.
The caregiver can notify the patient's request in
The social insurance office to a new replacement period shall begin
before the previous benefit period has expired.
Government, or the Government authority determines,
Announces rules on notification referred to in the third subparagraph and on
When a new replacement time shall begin to run.
4 a of for the calculation of the dental compensation under paragraph 4 shall
the costs for dental services, drugs, or other
care products adopted decision on compensation
According to section 10 of the Act (2013:513) for reimbursement of costs to the
due care in another country within the European economic
area is included. Team (2013:517).
section 5 Dental care payments may not be made for such
dental measures falling within the scope of an agreement
subscription dentistry under.
Dental health care may not be submitted for
dental measures to the extent that these are paid by
dental benefits. Law (2011:1189).
section 6 of the Government, or the Government authority determines,
Announces rules on
1. the amount of the patient's total dental care costs
during the benefit period must exceed in order to
dental health care should be provided,
2. what proportion of the total costs
excess of the amount provided for in paragraph 1 that dental reimbursement shall
be provided, as well as
3. reference prices for reimbursable
Dental operations.
Chapter 3. Health care providers
Conditions for obtaining State dental care
(1) to a health care provider should be able to receive compensation under this
law, the caregiver must be connected to the Swedish social insurance agency
electronic systems for State dental care.
The Government, or Government authority determines,
provide for the requirements of and termination of connection
to the electronic system for State dental care.
Healthcare provider's obligation to
section 2 of the health care provider is at the request of the health insurance fund or
the Court shall, in matters concerning State dental care leave
information, as well as showcase the journal and other materials relating to the
examination or treatment of a patient.
section 3 of the health care provider shall provide information to the Swedish social insurance agency
If
1. performed dental services, and
2. the content of agreements about subscription dentistry
According to Chapter 2. 2 § and if such an agreement has expired,
apply early.
The health care provider should provide information on the National Board of health and welfare
his patients ' dental health.
The Government or the authority, as the Government determines
may provide for the caregiver
obligation in relation to the Swedish social insurance agency
and the National Board of health and the health care provider information
must provide to a patient. Law (2011:1189).
Chapter 4. Other provisions
Insurance obligation
section 1 of the health insurance fund shall, at the request of a health care provider
provide the information the healthcare provider needs to
be able to calculate a patient's cost for dental care.
The repayment obligation
section 2 If a caregiver has received compensation under this Act
with an excessive amount, insurance agency require
back the benefit incorrectly paid.
Insurance agency may, instead of requiring
refund, counting of the amount from another claim which
the health care provider has for compensation under this Act.
The first subparagraph shall not apply to particular dental contribution, if
the caregiver has had reasonable grounds to believe that
the patient was eligible for such grants.
Law (2011:1189).
section 3 of the health insurance fund shall reclaim the consideration
provided to a health care provider who has performed a prosthetic
treatment needs to be done if, provided that the
new treatment
1. is not eligible as defined in
regulations issued pursuant to Chapter 1. paragraph 3 of the third
subparagraph, and
2. performed by another health care provider than the one that carried out the
treatment needs to be done.
Insurance agency may, instead of demanding repayment,
count of amount from another claim that the health care provider has to
compensation under this Act.
The insurance fund may provide remuneration to the healthcare provider
Repeat the treatment.
section 4 If the patient has provided incomplete or incorrect
information which led to the health care provider has not received the requested
compensation from the social insurance agency, the health care provider may require
the patient on the amount representing the difference between the requested and
the resulting compensation.
Prior authorisation
§ 5 in the case referred to in paragraph 3 of the first paragraph, the need to
do if the prosthetic treatment förhandsprövas of
The insurance fund before the new treatment.
5 a of the health insurance fund shall, at the request of a patient or
a health care provider make a preliminary determination as to whether the
the conditions for special dental contribution according to
Chapter 2. (1) (a) paragraph 2 is met.
Law (2011:1189).
section 6, If a health care provider
1. materially has breached the provisions of
This law, or in the regulations, adopted pursuant
the law, if the provider's obligations or conditions for
compensation, and
2. There is reason to believe that the health care provider will continue
to materially override provisions,
get insurance agency decide that the healthcare provider, to get
remuneration of certain dental tasks, in each case
shall request the prior authorisation of the insurance fund. Such a
decision shall be valid for a maximum of one year.
section 7 of the Government or the authority that the Government
determines Announces rules on when prior authorisation
in cases other than those referred to in paragraphs 5 and 6.
Law (2011:1189).
Application for and payment of State dental care
section 8 Of the health care provider should be able to receive compensation under this
law, the application for compensation be submitted to the social insurance Office
within two weeks of the dental action for which
reimbursement is requested has been completed. If there are special reasons,
can insurance agency pay compensation even if the application has
come in too late.
Insurance Fund shall pay compensation within two weeks from the
the application came in. If there are special reasons,
compensation will be paid later. Insurance agency may withhold
payment of compensation pending healthcare provider fulfils
their obligation under Chapter 3. section 3.
Appeal, etc.
subject to section 9 of this Act, apply, mutatis
parts of the following provisions of the social security code for
cases concerning State dental care:
-107 Cape. 9, 10, 12, 17 and 18 of the seizure, statute of limitations
and damages etc.,
-108. 2, 11, 15, 16, 19 and 21 sections and section 22 of the first
the paragraph on the repayment obligation and interest, etc.,
-110 Cape. section 13, section 14 (1) and (2) and section 31 and 115. 4 § about
obligation to provide accommodation,
-113 Cape. 2-17, 19, 20 and 21 of the amending, rethinking and
appeal.
The provisions of chapter 108. 2, 11, 15, 16, 19 and 21 sections and section 22
the first subparagraph shall not apply in the social code
relation to caregivers. Team (2013:110).
section 10 of the health care provider may not appeal against other decisions of the
The social insurance agency in cases where prior authorisation, other than those
referred to in paragraph 6. Decisions in cases of prior authorisation in accordance with paragraph 5 of
may, however, be appealed by the health care provider who has carried out the
treatment needs to be done.
section 11 of the Government, or the Government authority determines,
Announces rules on
1. application for and the calculation and payment of compensation
under this Act,
2. subscription dental care, as well as
3. prior examination.
Transitional provisions
2008:145
1. this law shall enter into force on 1 July 2008.
2. For dental measures that have been initiated before the entry into force
for older replacement provisions.
3. If prior authorisation has been requested before entry into force, the
older provisions on prior authorisation and reimbursement of the
Dental operations subject to preliminary examination.
4. A prerequisite for being able to receive compensation under the older
provisions is that the health care provider within four months from the
Dental operation completed successfully applying for compensation of
The social insurance agency. However, this does not apply to dental operations
subject to a prior examination as requested before the
July 1, 2008. For dental operations completed before the
september 1, 2009, applications for compensation made in
The social insurance office until september 1, 2011.
Law (2010:336).
5. The general dental care allowance must not be used for
payment under subscription dental care, if the patient
upon entry into force already covered by an existing agreement on
subscription dentistry. Older provisions on compensation in case of
subscription agreements entered into before the dental care
the entry into force.
2010:1322
1. this law shall enter into force on 1 January 2011.
2. Older provisions as regards section 2 applies
still for those covered by Council regulation
(EEC) No 1408/71 of 14 June 1971 on the application of
social security schemes to employed persons, self-employed
or members of their families moving within the community.
2011:1189
This law shall enter into force on 1 January 2012 in the case of Chapter 3.
paragraph 3 and the remainder on 1 January 2013.
2013:110
1. this law shall enter into force on 1 July 2013.
2. Older regulations apply for decisions rendered
before the entry into force.