WEDNESDAY, APRIL 14, 2021 | Roman

Dental Insurance: What are the benefits?

Dental Insurance: What are the benefits?

When comparing supplementary dental insurance, be sure to pay attention to the terms and conditions of the contract.

Some providers of supplementary dental insurance advertise that they will double the benefits provided by statutory health insurance. This may sound tempting, but if you do the math, you will quickly come to the conclusion that the double fixed allowance is only a drop in the bucket in some cases. Therefore, we would like to recommend that you study the wording of the conditions as closely as possible when comparing supplementary dental insurance. According to Stiftung Warentest, the criterion of the amount of benefits for dental prostheses should be taken into account when selecting a rate. Other additional benefits are comparatively only a “nice to have”. These include, for example, the allowance for periodontal and root canal treatments as well as for higher-quality dental fillings and professional teeth cleaning.


Waiting periods must be observed with supplementary dental insurance

Time and again, disappointed policyholders complain to the consumer advice centers about their supplementary dental insurance. In most cases, the complaint is about denied benefits, which are, however, legal. To avoid frustration in the first place, you should always remember that treatments that were already started before the contract was concluded or that were already considered necessary at that time may not be reimbursed by the insurance company as a matter of principle, which is related to the requirement of equal treatment of all customers.

The waiting periods that must elapse before the supplementary dental insurance kicks in should also be seen in this context. As a rule, such waiting periods are eight months, but they can vary greatly between providers. Most insurers cover this with staggered maximum benefit rates. Although there are now dental insurances without waiting periods, these are certainly not among the particularly favorable supplementary dental insurances.

Of course, there are situations where one would like to have supplementary dental insurance immediately. In fact, today there is what the advertising promises: a supplementary dental insurance that pays even when it is actually already too late. However, the advertised tariff for supplementary dental insurance with immediate benefit works with the considerable restriction that here only the GKV fixed allowance is doubled in the case of dental prostheses. In certain individual cases, this can be a lucrative emergency solution. Nevertheless, we at Stern advocate simply taking out supplementary dental insurance without any special frills in good time so as not to be overwhelmed by the premiums.

A representative example of such offers is the ERGO Direkt Zahn-Ersatz-Sofort (ZEZ) tariff, which promises immediate benefits without health questions or waiting periods. Although supplementary dental insurance without health questions sounds really tempting, it also has its price and the benefits behind it can be described as mediocre.

Almost every test for supplementary dental insurance comes to the conclusion that dental insurance without a waiting period or health questions is generally not an optimal solution and is by no means one of the most favorable supplementary dental insurances. If you are looking for the best supplementary dental insurance, you should definitely carry out a comparison of supplementary dental insurance, preferably at a time when your decision-making ability is not yet clouded by hammering toothache.


The two variants of private supplementary dental insurance

The supplementary dental insurances are offered in two forms: in the manner of a life insurance and comparable to a damage insurance. Both have an effect on the calculation of the premiums. In the case of the variant similar to a non-life insurance, the premium increases gradually with the age of the policyholder. If, on the other hand, the model used is that of a life insurance policy, the premiums are initially higher in order to generate age reserves for the patient. Although this makes sense at first glance, it ties the policyholder to his insurance company. If he decides to change providers one day, all the amounts for the age provision are lost.

Is it worth changing dental insurance?

There is no general answer to this question. The fact is that most supplementary dental insurance policies can only be terminated after two years, subject to certain deadlines. What you should do in any case is to look again at the different rates of the provider with whom you are already insured. If the latter has a better rate on offer than your current one in the meantime, you can switch within the house, so to speak, without being required to wait again. If you go to another insurance company, you will be treated as if you had never heard of supplementary dental insurance. In this respect, such a change should be treated with caution, especially if dental treatment is unavoidable in the near future. Also in this context, we refer to our dental supplementary insurance comparison.

As mentioned above, a supplementary dental insurance can only be cancelled after two years. After that, the cancellation is then possible every year until September 30, in order to subsequently change the insurance to the next January 1. In the event of a so-called premium adjustment, which is usually associated with an unscheduled rate increase, your special right of termination comes into effect. If you make use of this, you will lose your savings, provided it is a tariff with age provision.

What a good supplementary dental insurance should offer

As a minimum standard for a good supplementary dental insurance, we assume that dental prostheses, and this means implants in particular, are covered. This standard also includes unrestricted coverage of the costs of ceramic or gold inlays and ceramic veneers for crowns and bridges. Cost coverage means reimbursement of at least 50 percent. In the case of implants, it should be noted that the often preceding, lengthy bone augmentation, which is also quite expensive, is also covered.


Supplementary dental insurance for children

Dental prostheses play a minor role in supplementary dental insurance for children. In contrast, protective measures for prophylaxis, dental treatments and even orthodontic operations are almost the order of the day and cause high costs, which definitely justify supplementary dental insurance for children. Corresponding offers have mushroomed in recent years, and the many rates for supplementary dental insurance for children are as varied as the mushrooms in the forest. In the meantime, you can no longer avoid a dental insurance comparison in this genre.

Important benefits of supplementary dental insurance for children

Prophylaxis is one of the most important dental services for children. The GKV covers basic prophylaxis every six months for children between the ages of 6 and 18. However, in order to really protect children’s teeth in the long term, more extensive, individual measures are required, which the GKV does not want to have anything to do with.

About 65 percent of our children are affected by malocclusions. In the course of their adolescence, jaw adjustments are often unavoidable. Depending on the degree of malocclusion, these regulation measures are divided into five orthodontic indication groups. However, the GKV only covers treatment costs for standard treatment of the severity levels from “KIG 3” upwards, although treatments of levels 1 and 2 can be useful for children. This means that many parents face costs of 5,000 dollars and more. Depending on the tariff of the supplementary dental insurance for children, between 80 and 100 percent of this is covered.

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