What does dental supplementary insurance mean?
Public health insurance funds only cover a small proportion of the costs for dental treatment and dentures. They pay the “standard treatment” with a fixed rate of 60% and you have to pay for all additional services yourself (through bonus programs, you can get more percentages).
Dental supplementary insurance fills that and other gaps, by reimbursing you more money and getting you better treatment, better materials, etc.
What does it cover?
It depends a little bit on what plan you choose but we are talking about four main pieces of coverage:
What is the coverage sum?
The plans usually come in three variations: 80 %, 90 % and 100 %. That means that, depending on which plan you choose, you top up an additional 20 %, 30 % or 40 % to the 60 % paid by your public health insurance carrier.
Additionally, they came up with an extremely German word: the “Zahnstaffel”. This means that they pay you a maximum amount, depending on how long you have been with the carrier, for example: 1.000 € in the first calendar year, up to 2.000 € in the first two years and so on.
What is standard treatment?
It is written into law that the treatments covered by public health insurance need to be “economical, appropriate and satisfactorily”, which means: they need to get the job done and not much more. In practice this means the cheapest material for fillings, no ceramic for crowns, no teeth cleaning, etc. If you are in public health insurance and want better materials, you can to pay for it yourself, unless you have such a supplementary dental insurance.
Who is insured?
You can insure every family member you want, especially for kids the plans are often very cheap and cover a relatively high amount of orthodontic works. Ultimately, you can simply choose who you want covered individually, there are no family plans.
Can everyone join?
At the end of the day, the insurance companies want to make money, so they do ask you a few health questions. The most common ones are:
If you went to the dentist and they told you already that you need to get a treatment, then almost all carriers will not cover this particular treatment but you can still join for future treatments.
There are a handful of policies that you can take out even for a running treatment but we need to take a good look at the exact numbers because they often a) do not cover a lot and b) tie you to them with a long runtime.
Additionally, you can only join if you are a member of a public health insurance carrier.
Runtime of the plan
Most contracts run for a minimum of 12 months and then the carriers have different rules –some let you out daily after that, some make it dependent on whether you sent in claims.
