Additional dental insurance

Dipl. Vw. Lars Weiland (expert of the portal www.zahnzusatzversicherungen-vergleich.com)

Why supplementary dental insurance is worthwhile:

• For those with statutory health insurance, only simple cement fillings for a hole in a tooth are covered, which usually only last a few years and then have to be replaced. If you want a high-quality plastic filling, you will have to pay a co-payment of around €60 without insurance, while ceramic inlays can cost between €250 and €450. Anyone struggling with tooth decay therefore has to dig deep into their pockets for sustainable treatment. Depending on the tariff, however, the insurance may cover these costs in full.
• Another treatment that is necessary for many people is root canal treatment, which in many cases costs around €800 for those with statutory health insurance. High costs that could easily be covered by suitable supplementary insurance.
• Children who frequently require orthodontic treatment can also incur costs in the four-digit range under certain circumstances. Misaligned teeth of minor severity that require correction for medical reasons are still not covered by health insurance. The statutory health insurance only comes into play when the degree of deformity reaches the extreme. It therefore makes sense for children to take out supplementary dental insurance at an early age.
• However, good supplementary dental insurance not only supports you with necessary treatments, but also with preventive care so that pain does not occur in the first place. You can therefore have prophylaxis carried out twice a year in the form of professional teeth cleaning. The regular costs without insurance are between €60 and €150 per treatment.

The three-point plan – what you should bear in mind

1. which services do you use?

If you regularly take advantage of the recommended professional dental cleaning to maintain your oral health in the long term, it may be worthwhile taking out cover for this component. Also for dental treatment measures, such as a root tip resection, corresponding services can be integrated into the scope of supplementary dental insurance. The orthodontics and dentures modules can also be insured with various providers.

2 When does the insurance cover take effect?

Supplementary dental insurance protects you against future complaints. This means that a newly concluded supplementary dental insurance policy does not yet apply to current treatment measures or treatment measures that have already been declared necessary by the dentist before or during the conclusion of the contract. As many tariffs require health questions to be answered as part of the application process, it is not possible to conclude a contract in this case. However, those interested in taking out supplementary dental insurance despite current or advised treatment can switch to tariffs without health questions. In any case, however, the insurance cover only applies to future illnesses and any treatment measures that become necessary as a result.

3. get help from experts!

Due to the diverse range of tariffs, it is generally highly recommended to compare different tariffs independently. You can do this either with an independent local insurance broker or with an independent comparison on the Internet. With the online option, you can analyse the respective offers directly from home based on your individual requirements and, if necessary, clarify any questions that arise over the phone. You can find more information on this in the following section.

Find the right tariff: How to determine your needs

The goal

The central question when deciding in favour of private supplementary dental insurance is the scope of benefits. You need to be clear about which cover components the perfect tariff for you should include: Do you want all-round cover for all services, such as dental prostheses, treatments, prophylaxis and orthodontics, or just cover for individual partial measures? Firstly, you should think about which services make sense for your needs or could become relevant for you in the future. With this in mind, you can now determine the scope of your insurance.

The scope of services

The various supplementary dental insurance tariffs not only have different modules for prophylaxis, dental treatment, dentures and orthodontics, but also cover these benefits to varying degrees. So even if the various sub-components are part of a tariff, the benefits may be limited by maximum reimbursement amounts. For example, some tariffs do not cover implants or all-ceramic crowns or exclude root and periodontal treatments in their insurance conditions. Particularly in the case of children and adolescents, attention should definitely be paid to the sub-area of orthodontics, as there is a high potential for claiming benefits here.

The start of performance

As a rule, almost all supplementary dental insurance policies have waiting periods before the actual benefit period begins. Depending on the tariff and type of benefit (there is often no waiting period for prophylaxis), this can be up to eight months. It is therefore worth taking a closer look at the insurance and tariff conditions in advance. However, there are also tariffs that do not stipulate a waiting period for all benefit modules. In principle, however, this criterion should not be used as a basis for choosing supplementary dental insurance, as treatment measures that are already necessary cannot be billed anyway. However, if accident-related treatment measures become necessary after the start of the contract, the waiting periods do not apply and the insurance company will cover the full scope of the insured benefits.

Power limitation

A so-called dental scale defines the period after the start of the contract during which benefits are limited. This is often a period of four years, although this varies from tariff to tariff. No benefit modules are excluded here, but the insurance benefits are limited financially. Some providers work without such a limit in the initial period. In the case of so-called low-cost tariffs, a maximum reimbursement amount is often even fixed for the entire duration of the contract.

The costs

The insurance premium is largely determined by the entry age of the insured person. The rule of thumb here is the older the more expensive. Even if one might think that the amount of the premium is an indicator of the scope of the insurance, caution is advised here. This is not the case with many tariffs. The insurance premiums can be paid monthly, quarterly, semi-annually or annually. Many insurance companies even grant a discount for semi-annual or annual payments.

Development of contributions

There are two different types of calculation that determine the premium development for supplementary dental insurance. One is the calculation according to the type of life insurance and the other according to the type of indemnity insurance.
The premiums for indemnity insurance increase depending on age. In contrast, with life insurance, old-age provisions are factored in from the outset and the premium is kept constant despite increasing age. Accordingly, these tariff offers are also more expensive from the outset. This variant is therefore often only worthwhile for very young policyholders.

The health questions

With most tariffs, health questions are asked when the application is made which enable the insurer to carry out a risk assessment and, if necessary, reject the application. However, there are also some tariffs that do not ask any health questions. However, here too, dental treatment measures that were already started or advised before the application was submitted are generally not covered.

The duty to fulfil obligations

When applying, it is of the utmost importance that the health questions are answered truthfully. If illnesses are concealed or false information is wilfully provided, this constitutes a breach of the pre-contractual duty of disclosure. In the event of this so-called breach of obligation, the insurer is exempt from paying benefits and the premiums paid up to this point are lost.

The duration of the contract

Supplementary dental insurance is a long-term preventive insurance contract, so the duration of the contract should not be too important when making a decision. Nevertheless, there are differences in the minimum contract term of the various insurance providers. Most tariffs have a minimum contract term of two years. Some, on the other hand, only provide for a minimum contract period of one year. However, all tariffs have one thing in common: they can be cancelled at the end of an insurance year after the minimum contract term with a four-week notice period. If you don’t want to commit to a minimum contract term, you can take advantage of the services offered by Deutsche Familienversicherung or ERGO Direkt Versicherung, for example, which can be cancelled at any time at the end of the month.

This information was compiled for you by Dipl.-Vw. Lars Weiland, an expert from the zahnzusatzversicherungen-vergleich.com portal.