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When dental supplementary insurance pays off

2020-05-13T03:01:04.352Z


Supplementary dental insurance is particularly worthwhile for people with statutory health insurance if they want expensive dentures. Interested parties should take care early and compare services.


Supplementary dental insurance is particularly worthwhile for people with statutory health insurance if they want expensive dentures. Interested parties should take care early and compare services.

Berlin (dpa / tmn) - Whether crown, bridge, implant or inlay: dentures are expensive. Statutory health insurers often have to cover part of the costs out of their own pocket - depending on the state, up to 1228 euros for dentures, as statistics from the Barmer health insurance show.

Statutory health insurance (GKV) pays a fixed subsidy to insured persons - but usually only pays half of the costs for the so-called standard care.

"Supplementary dental insurance often doesn't pay off for anyone who is satisfied with the standard benefits of the GKV, such as a metal crown without facing," explains Elke Weidenbach from the NRW consumer center. If you do not have additional insurance and would like to receive health insurance benefits, you should inform your dentist about this.

Supplementary dental insurance is particularly worthwhile for people who value high-quality dentures, explains René Neumann from the Association of Private Health Insurance. "With the policy, health insurance patients can reduce their own contribution and cover up to 100 percent," says Neumann.

These requirements must be met

However, in order for the contract to come into being or for the insured to pay the regular contribution, the dentist should not yet have classified a tooth as requiring treatment.

Weidenbach therefore advises: "In the mid-30s, protection should ideally exist." It refers to statistics according to which dentures are often only necessary from the mid-30s to the early 40s.

Those who want to take out dental insurance usually have to answer a few health questions. "Consumers should answer the questions correctly, otherwise they risk their insurance cover," explains Weidenbach.

Compare prices and services exactly

The amount of the premium depends, among other things, on the insured person's entry age, but also on the benefits and the condition of the teeth. It is therefore not possible to make a generalized estimate of how expensive such a policy is. There are also contracts where the contribution increases with age.

Before concluding a contract, consumers should consider exactly what benefits dental supplement insurance should cover. In addition to the costs of dentures, some tariffs also cover the costs of professional tooth cleaning or orthodontics. It is worth comparing the services and prices.

Different options for the assumption of costs

There are also various options when it comes to assuming costs. "For example, the insured person is reimbursed a flat percentage, about 30 percent of the total invoice amount," explains Neumann. The flat-rate percentage is usually limited to a maximum of 80 or 90 percent of the invoice amount. The share of other insurance providers is taken into account, i.e. the SHI share.

Another option: the insured person is reimbursed a flat percentage of the remaining costs after advance payment from the statutory health insurance.

The insurance company should always reimburse 2.3 times the standard maximum rates of the Schedule of Fees for Dentists (GOZ). "A limitation up to the maximum rate of the GOZ, the 3.5-fold rate, is usually sufficient," says Weidenbach.

In addition, the contract should not limit the amount of the annual reimbursement. Because if this is around a maximum of 10,000 euros, the policyholder remains at a larger dental treatment at costs that exceed this framework.

test: Dental supplement insurance

Barmer: Dental Atlas

Source: merkur

All life articles on 2020-05-13

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