Dental insurance
A dental insurance is a special form of health insurance , which at a private health insurance can be completed. It covers risks that are not or only partially covered by the statutory health insurance providers and thus enables their services to be supplemented financially.
Background and design
The benefits of the additional dental insurance can cover different risk areas depending on the structure of the respective insurance tariff. The term includes, in particular, the reimbursement of the costs of dental treatments such as prophylaxis , orthodontics , dentures and dental treatments. Depending on the respective service portfolio of the tariff, the individual service areas are covered to different degrees or comprehensively. The insurance companies usually fall back on a percentage of benefits linked to the invoice amount. Less often, the same amount of the " fixed allowance " is paid, which is paid as a fixed amount by a statutory health insurance provider .
Supplementary dental insurance reduces the portion of the dental bill that is borne by the patient himself. Since the statutory health insurance exclusively for services of regular health care comes up, patients need to further achievements wish (private medical care) how similar or different type of services (for example, fixed dentures as a bridge instead of a removable partial denture) pay the difference to the fixed subsidy itself. The same applies to the additional costs of a ceramic filling or a gold inlay compared to the amalgam filling paid for as a benefit in kind under statutory health insurance . Furthermore, additional dental services such as prophylactic treatment can also be covered.
Additional dental insurance is calculated differently (see next paragraph “Types of additional dental insurance”). A part contains old age provisions in the contributions, which are (initially) more expensive. Another part does not create any provisions, so their contributions increase regularly. A comparison with each other is difficult and only possible by considering all contribution amounts over the entire term.
Types of tariff for supplementary dental insurance
There are two types of supplementary dental insurance: tariffs by type of non- life insurance and tariffs by type of life insurance ; They differ mainly in how the insurance companies calculate the monthly premiums:
According to the type of damage insurance
Non-life insurance tariffs are the most common form of supplementary dental insurance. With this type of tariff, the contribution can not only be increased due to increases in health care costs, but also as planned as the age of the insured increases. Given the higher number of offers, customers have more choice here. Non-life insurance tariffs are often significantly cheaper for young customers, but become more expensive in old age than life insurance tariffs.
By type of life insurance
Life insurance tariffs are the second variant of dental policies: With them, the premium depends on the age of the insured person when the contract was signed. Life insurance-type tariffs use part of the monthly premium from the outset to build up an aging reserve , which is then available for older people. There are therefore no age-related increases in premiums after the contract is concluded. However, later premium increases are permitted with the consent of a trustee (trustee procedure). The insurers are not allowed to terminate current contracts.
If an insurance customer changes within an insurance company to another additional dental tariff, which is also calculated according to the type of life insurance, his provisions will be credited to him there.
However, with both types of supplementary dental insurance, it should be noted that the monthly premiums agreed upon when the contract was concluded are not guaranteed for the entire term of the contract: the insurer always has the option of a premium adjustment due to cost increases in the health care system or deterioration in the capital market . It is currently not foreseeable whether one of the two types of tariff will have more stable contributions in the long term.
Tariff comparison
There are over 300 different dental insurance tariffs on the German insurance market. The structure of the tariff details is so different from insurer to insurer that comparing the tariff structures is extremely difficult for the layman, but also for the insurance broker. Furthermore, the choice of the “right tariff” is subjective and cannot be generalized. Comparison calculators and brokers offer a corresponding selection of tariffs that recommend tariffs that should be tailored to the respective needs. Services that go beyond the standard services - such as dentures - should also be included in the contract decision. Mostly the premiums, but not the actual scope of services in the event of damage, are compared with one another. Many insurers advertise with one hundred percent assumption of costs - in the tariff description it is then stated restrictively that it is only a matter of assuming the costs of the co-payment up to the amount of double the fixed allowance for dentures. Additional costs that result from different types of care are often not included, so that despite additional insurance, considerable co-payments remain as soon as you have not decided on basic care. Services that are not included in the catalog of the health insurance company, so-called non-contractual benefits, are not reimbursed if the tariff contains the clause “after advance payment by the health insurance company”.
But there are also insurers who calculate their benefits independently of the fixed cost subsidy and pay them out without taking into account the advance payments made by the statutory health insurance. These are premium tariffs, which are naturally somewhat more expensive but offer the customer extensive, private medical insurance up to the maximum rates of the dentists' fee schedule (GÖZ). The benefits of the statutory health insurance are paid out in addition to the benefits of the private supplementary dental insurance, so that reimbursements of 100% of the total invoice amount are achieved. This also applies to high-quality dentures such as implants. If the advance payment by the statutory health insurance company is omitted, because the service is not defined in the dentists' fee schedule but not in the statutory health insurance company's catalog of services, it will still be paid by the additional dental insurance within the scope of the contractually agreed reimbursement of costs. If the sum of the reimbursement by the statutory health insurance and the additional dental insurance exceeds 100% of the total costs, the additional dental insurance reduces the service provision accordingly. Withdrawals over 100% are not allowed.
When choosing the right insurance, a variety of other criteria must be checked in addition to the contribution amount. The respective insurance conditions of the individual insurance companies play a significant role here. Usually there are further clauses there that have a significant impact on the quality of supplementary dental insurance. These include, for example, waiting times, graduated tariffs, maximum limits on reimbursement or special reimbursement requirements.
Policies in the test
In its investigation of supplementary dental insurance in August 2014, the magazine Finanztest of Stiftung Warentest came to the conclusion that the level of performance of the policies has generally improved considerably in recent years. The Foundation therefore recommends that owners of supplementary dental insurance taken out before 2010 should check the scope of benefits and change the tariff if necessary.
In November 2016, the magazine Finanztest published a ranking of supplementary dental insurance. A total of 209 supplementary insurances for those with statutory health insurance were tested. Out of a total of 209 tariffs, 66 received a “very good” and 59 a “good”. 58 were rated “satisfactory” and 26 as “sufficient”. Deutsche Familienversicherung provided the best tariff, followed by DKV.
In contrast to 2014, Finanztest took into account both supplementary insurance with and without aging provisions in this analysis.
In May 2018 Finanztest again compared the supplementary dental insurance with each other. Now three tariffs share the top spot with a test grade of 0.5 "very good". It should be noted, however, that it was again only an assessment of the performance of the tariffs and the price-performance ratio was ignored.
Unisex tariffs
" Unisex tariffs " have also applied to supplementary dental insurance since 2013 , meaning that there are no gender-specific differences in tariffs, so women and men pay identical contributions.
development
The number of private dental supplementary insurance policies practically doubled between 2005 and 2015: from 7.79 to around 15 million contracts. In 2018, the number of private dental supplementary insurance policies rose to over 16 million.
Web links
Individual evidence
- ↑ test.de : Supplementary Dental Insurance (October 9, 2016)
- ↑ test.de , January 20, 2015: FAQ supplementary dental insurance: What does the private supplementary policy bring? (January 22, 2015)
- ↑ test.de , July 15, 2014: Supplementary Dental Insurance : Getting a Tooth (24.11.2017)
- ↑ test.de , November 17, 2016: Additional dental insurance in the test: 66 out of 209 tariffs are very good ( November 24 , 2017 )
- ↑ Test in financial test 11.2017 (24.11.2017)
- ↑ fr-online.de , October 28, 2012, Sebastian Wolff: Gold im Mund (October 9, 2016)
- ↑ haufe.de , August 12, 2016: Supplementary insurances for dentures are booming (October 9, 2016)
- ↑ Over 16 million Germans have additional dental insurance (October 4, 2019)
