“Do you have private supplementary dental insurance?” Are you always overwhelmed with this question on the treatment chair at the dentist? We clarify what the policy can do and whether it is recommended.
Education and personal initiative – this is what dental health has been focused on in Germany for 30 years. And it works: The proportion of dental health costs has been falling for health insurance companies for years, says Angelika Brandl-Riedel from the German Dental Association (DZV). The question is: If the health insurance companies cover the costs of dental problems, why do you need additional insurance?
What does supplementary dental insurance do?
Statutory health insurance generally covers the costs that are necessary for adequate, appropriate and economical dental treatment. “Without a bonus booklet, this fixed subsidy amounts to 60 percent of the standard benefits defined depending on the findings,” says Peter Grieble from the Baden-Württemberg consumer center. The bonus book pays off:
- With a complete bonus booklet over the past five years, there is a 70 percent subsidy.
- Anyone who can prove even ten years of seamless provision gets 75 percent.
- The insured persons have to pay everything else themselves.
The situation is different with additional dental insurance: here the insurers cover other parts of the treatment costs. The more reimbursement of costs, the higher the contributions are usually, says Grieble.
Supplementary insurance: Prioritize deals
But when does it make sense to take out this insurance? “If all other life risks with a higher potential for damage are already insured,” says Grieble. Additional dental insurance covers a risk that can only be in the low five-digit range at most. “There are therefore more important types of insurance such as private liability, occupational disability, child disability, building and household contents insurance.”
Grieble recommends prioritizing degrees. “Otherwise you have insurance for lower risks, but there is no money left for the more important ones.” This is shown by years of consulting experience.
DZV chairwoman Brandl-Riedel emphasizes that basic care in Germany is provided in an exemplary manner. That’s why no one in Germany with statutory health insurance would have to go without teeth. But sometimes there are special requests. Example: tooth veneers. “Some patients want all their teeth white,” says Brandl-Riedel. However, the health insurance company only pays for white veneers on dental crowns in the visible area.
Additional dental insurance is not necessary for young people
Anyone who is interested in high-quality dentures – especially implants, bridges or crowns – can, according to the consumer advice center, be well advised to take out supplementary dental insurance. If normal care is sufficient for you, the policy is usually not worth it. The consumer center also advises young people against such insurance: “Statistically speaking, dentures are only necessary from the age of mid-30s to early 40s.”
Good to know: Dental problems that already exist at the time the insurance is taken out are often excluded from the policy – if there is an offer at all, according to the consumer advice center. Insurance companies ask about things like these before concluding a contract in connection with health questions. Only then does the insurer decide whether and under what conditions he or she will offer a contract. “Bad teeth and age can lead to higher contributions,” says Grieble.
Important: A tariff that fits
In general, according to Grieble, when taking out additional dental insurance you have to make sure that the tariffs match what you want. “There is often no better or worse – but rather clauses that fit the needs or not.” The clauses, for example, deal with the scope of the services, including services that go beyond dentures. Possible orthodontic treatments, the length of the waiting times or the existence of an annual benefit cap are also often set.
Because of the wide variety of markets, Grieble recommends that you consult a broker or fee-based advisor before closing. They ask about individual wishes and needs. “On this basis, a suitable offer is created.”
Brandl-Riedel also recommends contacting an independent insurance advisor. “It’s about the contents of such an additional insurance.” With an aging population structure, the cases of periodontitis increased: the teeth wobble and the gums bleed. Insurance must be tailored to this.
Have the estimate approved
Anyone who is actually thinking about taking out additional dental insurance can postpone or even suspend any upcoming treatments until the protection takes effect, says Brandl-Riedel. “This applies as long as the tooth is not acutely diseased and is well cared for.”
But be careful: some supplementary dental insurance takes effect immediately after taking it out if no waiting period has been agreed. “But there are a lot of restrictions and exceptions in the tariffs,” says Grieble. One of these is often when the dentist had already recommended treatment before the insurance began.
According to Brandl-Riedel, anyone who already has additional dental insurance and needs treatment would do well to submit an existing cost estimate to the insurer and have the procedure approved. This way, as a patient, you can be sure that you will not be stuck with some of the costs later.
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