Is dental implantation an expensive treatment and why are implants so expensive?

Conditions for expensive treatment For whom you can get a deduction Amount of deduction and deadlines for submitting documents Expensive dentistry How to get a deduction for treatment Documents for deduction

To understand in detail what a tax deduction for treatment is, we suggest watching our video.

Using illustrative examples, we tell you who has the right to a deduction, what documents need to be collected for the tax office, for whom you can get a deduction, and how much money you can ultimately return to your account.

The fundamental difference between simple and expensive treatment is the size of the tax deduction. The article “Medical services, medications and expensive types of treatment for tax deduction” lists the types of treatment approved by Decree of the Government of the Russian Federation of April 8, 2020 No. 458.

In order to find out the type of treatment you need, it is not necessary to look for the disease in the long list of the Regulations. Ask the clinic where you were treated for a “Certificate of payment for medical services to be submitted to the tax authorities” and look at the line “service code”.

If the code is No. 1 , it means the treatment was simple. If code No. 2 - expensive.

In a separate article, we described in detail what the “Tax Deduction for Treatment” is. Below we will tell you how to determine whether the treatment was expensive, what this means, what benefits it brings and how to get part of the costs back.

Is dental implantation an expensive treatment?

The cost of installing implants is affected by:

• Clinic category . In large dentistry with a large flow of patients, there is competition, so the cost of services may be lower than in small institutions. In Moscow and St. Petersburg, taxes and the cost of renting premises are higher, so prices for services are several times higher than in the provinces.
• Doctor's qualifications . Attending seminars and advanced training courses is expensive, so treatment from an experienced doctor will be more expensive. The availability of permits will also affect the cost. Registration and updating of documentation requires financial investments.
• Applied technology of implantation:
• classic in 2 stages;
• basal;
• express method;
• laser;
• mini-implantation.

In addition to the dental implant and superstructures, diagnostic procedures, consumables and repeated surgical interventions are paid for.

How to fill out the “Deductions” section in 3-NDFL for expenses on dental prosthetics (example)

The list of medical services (approved by Government Resolution No. 201) is not subject to broad interpretation, so it will not be possible to receive an unlimited deduction for expenses, for example, on dental prosthetics - this is the wording of medical services that is not in the List.

Let's supplement the conditions of the previous example to understand how to calculate personal income tax when making expenses for dental prosthetics.

Example 2

Engineer Kulikov Z.N. in 2021 spent his own savings in the total amount of 363,000 rubles. for your treatment, including:

• 182,000 rub. for joint replacement (medical code);
• 14,000 rub. for diagnostic procedures (code “01”);
• 167,000 rub. for dental prosthetics (code “01”).

To calculate the amount of personal income tax to be returned from the budget, it is necessary to determine the amount of expenses for treatment that is not considered expensive:

SL = 14,000 rub. + 167,000 rub. = 181,000 rub.

Since SL > 120 thousand rubles → SL = 120,000 rubles.

Personal income tax return = (182,000 rub. + 120,000 rub.) × 13/100 = 39,260 rub.

Instead of the calculated amount of treatment costs (181,000 rubles), 120,000 rubles are included in the formula. – the limit established by clause 2 of Art. 219 of the Tax Code of the Russian Federation.

When filling out the 3-NDFL declaration for treatment, Z. N. Kulikov indicated in the “Deductions” section:

Calculating personal income tax and filling out a declaration is only part of the actions of the general scheme for obtaining a deduction for treatment. An important stage of this process is the collection of supporting documents - more on this later.

Why are dental implants so expensive?

There are now more than 300 brands of dental implants. Production, research and development and materials require high costs, so products cannot be cheap. Important indicators in the manufacture of implantation systems:

1. Material . Typically, artificial roots are made from titanium alloy Ti-6Al-4V, which contains a small amount of aluminum and vanadium. Impurities give titanium strength, but slow down osseointegration (the process of fusion of the implant with the jaw bone). Manufacturers of premium structures use pure titanium 4 (G4Ti), which does not contain impurities. Metal-free ceramics and an alloy of zirconium dioxide with titanium are also used as materials. Ceramic rods are suitable for people with diseases of the mucous membrane and allergic reactions to metal.
2. Surface type . The implant surface is an important factor responsible for the rate of osseointegration. Basic surface treatment consists of sandblasting with titanium oxide or alumina and acid etching. This technology has the international name SLA and provides a rough, porous surface. After treatment, the surface can be coated with various chemical compounds that accelerate the synthesis of bone tissue. These compounds include calcium phosphate, fluoride ions and phosphorus.
3. Implant shape and thread types . When choosing an implant, the shape and type of thread are essential. Each model interacts with the jawbone differently. There are 4 types of bone: D1, D2, D3 and D4. D1 is the densest type, D4 ​​is the softest. High-density bone provides good primary stability but has fewer blood vessels, so osseointegration will occur more slowly. The softest type D4 is a poor option for implantation. The most favorable bone types are D2, D3.

For dense bone, cylindrical and conical implants are suitable. Too coarse carving is contraindicated in this case, since high tension in the bone will promote atrophy. It is good when the microthread is cut in the neck of the rod, and in its lower part the thread is moderately pronounced. For soft types of bone, conical-shaped structures with self-tapping threads are suitable.

The dental system is selected depending on the density and volume of the alveolar process of the jaw, the place of implantation (aesthetic or chewing zone), and the method of prosthetics.

Differences between budget and expensive implants

Conventionally, all dental structures belong to three main groups:

• Premium systems from well-known manufacturers. Such companies invest a lot of money in research, experiments, new developments, and not just in the manufacture of suprastructures and rods. They develop training programs for doctors and constantly modernize production methods. All this affects the cost of finished products and this is not surprising. This group includes products from Astra Tech (Sweden), Nobel Biocare and Straumann (Switzerland), as well as XiVe Friadent (Germany).
• Middle price segment. This category contains manufacturers who do not develop this industry, but only copy the methods of companies from the premium segment. Some samples are not the best, since it is not always possible to completely copy the original. However, there are products that, if installed correctly, can be used for a very long time. Here we can mention the products of MIS and Alpha Bio (Israel), Ankylos (Germany) and Bicon (USA).
• Products with limited functionality. Systems in this group are produced by small budget companies. We are talking about Russian, Ukrainian and Belarusian manufacturers of dental structures.

How do cheap ones differ from expensive ones?

Conventionally, dental implants can be divided into three large groups:

• Premium systems from leading companies. In addition to the production of rods and suprastructures, such companies invest a lot of money in development, histological research, and testing. They create training programs for dentists and continuously improve production technology. Ultimately, this is reflected in the cost, which is quite justified. Such designs include Swedish Astra Tech, German XiVe Friadent, Swiss brands Straumann and Nobel Biocare.
• Mid-segment designs . The second group includes companies that do not make a significant contribution to the development of implantology, but simply repeat the developments of manufacturers of the first group. It is not always possible to recreate an exact copy, so some samples are not entirely successful. However, there are models that, in the capable hands of a surgeon, can last a long period. These brands include the Israeli Alpha Bio and MIS, the American Bicon and the German Ankylos.
• Designs with low functional capabilities . Models in this category are manufactured at small budget enterprises. Such dental systems include Belarusian, Russian and Ukrainian.

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How to get a deduction for treatment

The process of applying for a tax deduction for expensive treatment is no different from the general rules. The main thing is attentiveness, scrupulous collection of documents and correct filling out of the 3-NDFL declaration.

On the one hand, nothing complicated. On the other hand, even a minor mistake can lead to you having to start all over again. Considering that tax authorities take three months for a desk audit, incorrectly completed documents will stop the process and you will waste time.

What will you get if you register in the online service NDFLka.ru:

• We will compile for you a list of documents you need;
• We will check the correctness of the design;
• We will fill out the 3-NDFL declaration for you or help you do it yourself;
• We will send you two electronic formats of 3-NDFL: XML and PDF, so that it is convenient for you to submit the declaration to the Federal Tax Service;
• or we will send 3-NDFL to the tax office ourselves using your electronic signature;
• We will be in touch until you receive the money in your bank account.

What does the final price consist of?

The final cost of implantation depends on the costs at each stage:

1. The preparatory stage includes sanitation of the oral cavity, consultations with specialists, and collection of samples.
2. The diagnostic stage involves an orthopantomogram and computed tomography.
3. If there is insufficient bone tissue, directed regeneration, sinus lifting or bone block grafting is performed.
4. Surgical stage. The doctor forms a bone bed, screws in the implant and sutures the mucous membrane.
5. After 3-5 months, the gum former is installed. To do this, the doctor dissects the mucosa, removes the temporary plug, and installs the former.
6. After 2-3 weeks, when a cushion of gum tissue forms, the former is removed and an abutment is installed in its place.
7. Prosthetics. Impressions are taken from the jaws, from which artificial crowns will be created in a dental laboratory.
8. Fitting, correction, fixation of the structure in the oral cavity.
9. Rehabilitation. The patient regularly visits the dentist to monitor the functionality of the prosthesis and the condition of the tissues.

Certificate from a medical institution

When submitting documents to the tax office for a personal income tax refund for treatment, special attention should be paid to the certificate issued by the medical institution.

This paper will be needed if medical expenses have been paid.

IMPORTANT! The form of the certificate of payment for medical services was approved by order of the Ministry of Health and the Ministry of Taxes of Russia dated July 25, 2001 No. 289/BG-3-04/256.

At the same time, other documents confirming the fact of payment (receipts, checks, bills, etc.) are not needed, since this certificate is issued only if the services have already been paid for. This position is shared by both officials of the Ministry of Finance and tax authorities (letters of the Ministry of Finance of Russia dated March 29, 2018 No. 03-04-05/20083, dated April 17, 2012 No. 03-04-08/7-76, Federal Tax Service of Russia dated March 7, 2013 No. ED- 3-3/ [email protected] ).

See the material “Certificate or checks for treatment? The Ministry of Finance says - a certificate.”

Such a certificate can also be obtained after undergoing sanatorium-resort treatment. At the same time, it will not indicate the cost of the voucher, but only the price of treatment (less expenses for food, accommodation, etc.) and the amount of additionally paid medical services.

If you have the above certificate and the type of service provided is included in the list, to receive a deduction you will need 2 more documents from the medical institution that provided the service: a contract and a license. If the medical institution does not have a license to carry out medical activities or the treatment was carried out not by a Russian, but by a foreign clinic, the deduction will be denied.

Tax officials must provide a certified copy of the agreement with the medical institution. Particular attention should be paid to the terms of this document if expensive treatment was carried out, and you purchased materials or medical equipment at your own expense that were not available in this clinic. This will allow you to receive a full deduction.

The license is presented in the form of a certified copy. It is not necessary to attach a license separately if its details are specified in the contract.

What you can and cannot save on during treatment

The professionalism of the doctor and the quality of the materials used are directly dependent on the pricing features of the clinic. List of acceptable ways to save:

1. Buy health insurance. Sometimes clinics provide discounts to patients who are treated under insurance programs.
2. You can refuse a temporary artificial crown if the chewing area is being prosthetized.
3. Perform implantation on several teeth at the same time. This will help save on making impressions, anesthesia and x-rays.

Is implantation an expensive procedure?

The cost of dental implantation depends on the following factors:

• Category of dentistry. In large clinics with a large number of patients, competition remains, and therefore services can be provided at more affordable prices compared to small centers.
• Doctor's professionalism. Training in advanced training courses and specialized seminars costs a lot, so the services of an experienced person are not cheap. The cost of treatment is also related to whether the clinic has all the permits. Receiving and updating them entails monetary costs.
• Method of implantation used: traditional 2-stage;
• express technology;
• basal;
• mini-implantation;
• laser

In addition to the implant itself and the superstructure, it is necessary to pay for diagnostics, multiple surgical interventions and various consumables.

How to get back part of the money spent on implantation

The list of costly types of treatment was approved by Decree of the Government of the Russian Federation No. 201 of March 19, 2001 . According to point No. 9, dental implantation is defined by the Ministry of Health as an expensive type of treatment. When drawing up a certificate of payment for medical services for the tax authorities, the attending physician enters a code that means that the treatment is included in the category of cheap, and “2” - in the category of expensive. For implantation, coding “2” is used. Prosthetics with implants is not included in the list.

What is a tax deduction - when and how much you can save

A tax deduction is an opportunity for a taxpayer to return 13% of the amount spent on treatment. The right and procedure for payments is regulated by the following regulations:

• Article No. 219, clause 1, clause 3 of the Tax Code of the Russian Federation provides that every taxpayer has the right to receive an annual monetary compensation in the amount of 13% of the amount spent on treatment in any medical institution in the country.
• Decree of the Government of the Russian Federation dated March 19, 2001 No. 201 regulates the procedure for obtaining tax deductions and provides a list of medical services that are subject to compensation.

A percentage of the amount spent is accrued for the following services:

• medical procedures provided to the taxpayer or his immediate relatives (children under 18 years of age, spouse, parents);
• medications prescribed by a doctor;
• paid premiums to the insurance company based on the personal health insurance agreement.

The tax deduction is calculated on the total amount of expenses and cannot exceed 120,000 rubles during the year. If the taxpayer intends to compensate for expenses spent on treating relatives, the maximum payment amount will be 50,000 rubles.

What documents need to be collected and where to submit them?

List of required documents:

• an application for the provision of a tax return addressed to the head of the tax authority;
• application for transfer of funds to the taxpayer’s personal bank account;
• a certificate of the established form with the coding of the medical service from the clinic where the treatment was actually carried out;
• a copy of the patient’s agreement with the clinic (with a list of services provided and their cost);
• a copy of the clinic’s license to provide these services;
• document confirming payment for the service (cash receipt);
• a copy of the tax registration certificate (TIN);
• copy of the passport;
• certificate 2 personal income tax from the place of work;
• declaration in form Z-NDFL;
• if the service is provided to a family member of the taxpayer, then additionally provide a document confirming the relationship (birth or marriage certificate).

These documents must be submitted to the tax authority at your registration address.

For whom can you get a deduction?

A common situation is when one person in a family is treated, and the other pays for it. This often happens to elderly parents, because paying tens of thousands of rubles for joint surgery or therapy for a serious illness is an unbearable burden for a pensioner.

In Art. 219 of the Tax Code of the Russian Federation defines a list of relatives for whom you can receive a tax deduction if you paid for their treatment:

• husband wife;
• children under 18 years of age;
• parents.

If you are paying for yourself or for relatives from the above list, an agreement with the clinic can be concluded for any of you. The main condition is that there must be documentary evidence that it was you who incurred these expenses.

Average cost in Moscow

Expensive dentistry

The most popular question is what dental service is considered an expensive treatment? Is it possible to get a tax deduction for all expenses for prosthetics, braces or dental treatment?

Let's turn to the Decree of the Government of the Russian Federation of April 8, 2020 No. 458, which defines a list of expensive types of treatment.

It contains point 1:

Medical services for orthopedic treatment of the population with congenital and acquired defects of teeth, dentition, alveolar processes, jaws supported by dental implants in the absence of conditions for traditional dental prosthetics (significant atrophy or defects of the inert tissue of the jaws).

This is the only indication of a service that can be classified as dentistry. Or rather, to surgical dentistry for implantation of dentures.

Let's summarize: no matter how much money you spend on prosthetics, installation of braces or dental treatment, only the operation of implanting dentures is an expensive type of treatment . And only for it and for the implants you can get a tax deduction for the entire amount.

All other dental services are classified as simple treatment with code No. 1 with a maximum tax deduction of 120 thousand rubles and a payment of 15.6 thousand rubles (13% x 120 thousand rubles).

Remember that the amount of all social deductions, including treatment, cannot exceed 120 thousand rubles.

Possible savings during treatment

The experience of the dentist and the quality of the materials used are directly related to prices at the chosen medical institution. You can save money in the following ways:

• Registration of an insurance policy. Some clinics offer special discounts to people whose treatment is covered by health insurance programs.
• Simultaneous installation of dentures on several teeth. Thanks to this, you will not have to spend extra money on painkillers, impressions and x-rays.
• Refusal to install a temporary crown when installing an implant in the chewing area.