5.12. Dental care

With a few exceptions (removable dental prostheses for persons aged 18–60; technical dental costs for people under 18, students in a full-time course of studies and for people over 60; dentures for people under the age of 18, all of which require co-payments), most dental services are available free of charge within the single-payer health insurance system (1993/5, 1997/15, 1997/18, 2003/15). Dental care is divided into three services: (1) dental primary care, including, among other things, dental screening, school dental services and dental services for pregnant women, (2) dental specialist care and (3) dental out-of-hours services. Dental primary care is organized on a territorial basis similar to that for family doctor services, but unlike family doctors, patients are not allowed to choose their primary care dentist freely.

Dental care is reimbursed using a mixed payment system consisting of a fixed fee and a fee-for-service point system, the latter being the same as that used for all other outpatient specialist services (1997/19, 1999/1). The fixed component of the payment for dental primary care is a capitation payment adjusted for the age structure of the population served (calculated in terms of points and weights), and it is very similar to the capitation of family doctor services in so far as the fee paid per capitation point decreases above a certain number of capitation points. In the case of dental specialist services, there are fixed numbers of capitation points for 30 hours of surgery per week, and they decrease proportionately for fewer weekly hours of surgery. The capitation fee (HUF per point) is set in a governmental decree. Finally, in the case of dental out-of-hours services, the fixed fee (defined as a lump sum in HUF) depends on the number of inhabitants (fewer than 50 000; 50 000–100 000; over 100 000) and the number of duty hours per day (1999/1).

In Hungary, private provision is dominant is dental care. The development of private dental care capacities was facilitated by cross-border dental care and health tourism in general. The phenomenon started in the early 1980s, and was originally limited to the border regions with Austria. According to certain studies, Hungary is the target country for over 40% of all dental tourism in Europe, with about 63 000 patients visiting Hungary every year for dental treatment. Patients come mainly from the UK (30%), Ireland (20%), France (15%) and Austria (15%). It is estimated that about 15% of all dentists and an additional 5000 skilled workers are involved in cross-border dental care in Hungary (Kámán, 2010).