Dental insurance in comparison
Calculator for cheap rates for dentures and prophylaxis
The statutory health insurance (GKV) takes over for dental treatment and dentures only a part of the costs. The own shares for the insured have been increasing for years. On average, insured persons insured for dentures have to pay 854.16 Euro (Barmer Zahnreport 2016) out of their own pocket. If you want to keep your smile and spare your wallet, you can cushion the co-payments with a private dental insurance.
Why is private dental insurance useful??
The benefits of private dental insurance are obvious. The statutory health insurance no longer pay any treatment. Higher co-payments and benefit cuts also worsen the benefits of the statutory health insurance in the area of dental treatment. With a dental insurance insurance also have insurance policy the opportunity to be treated like a private patient at the doctor. But not every additional policy makes sense. In principle, additional insurance is always recommended if high medical care is important or if the additional payment represents a high financial burden.
Hallesche Dent fares in comparison
| Hallesche GIGA.Dent |
Halle MEGA.Dent |
Halle SMART.Dent |
|
| Dentures with standard care | 100% (including SHI) | 100% (including SHI) | 100% (including SHI) |
| Dentures with private services (including implants) | 90-100% (including SHI) * | 80-90% (including SHI) * | 90% (including SHI) |
| inlay | 90-100% (including SHI) * | 80-90% (including SHI) * | 90% (including SHI) |
| fillings | 100% (including SHI) | 100% (including SHI) | 100% (including SHI) |
| root canals | 100% (including SHI) | 100% (including SHI) | 100% (including SHI) |
| periodontal disease treatment | 100% (including GKV), if GKV makes | 100% (including GKV), if GKV makes | 100% (including GKV), if GKV makes |
| prophylaxis | 2 x 80 € in the KJ | 2 x 80 € in the KJ | 2 x 80 € in the KJ |
| Orthodontics (KfO) children | KIG 1-5: 100% to 1,000 €, even without GKV-advance | KIG 1-5: 100% to 1,000 €, even without GKV-advance | KIG 1-5: 90% to 3.000 €, without GKV-Vorleistung: KIG 3-5: 50% to 3.000 € |
| KfO in case of accident | 100% | 100% | 100% |
| Anesthesia / acupuncture for dentures | 90-100% * | 80-90% * | – |
| Anesthesia / acupuncture for dental treatment | 100%; Analgo, laughing gas treatment and acupuncture up to 250 € / year | 100%; Analgo, laughing gas treatment and acupuncture up to 250 € / year | – |
| dental Season | For dentures ZE: € 1,000 in the 1st KJ, 2,000 € in the 1st -2. KJ, 3.000 € in the 1.-3. KJ, 4.000 € in the 1.-4. KJ, 5,000 € in the 1st-5th KJ, after that unlimited; |
For dental treatment (ZB) and KfO ges .:
500 € in the 1st KJ,
1.000 € in the 1.-2. KJ,
1,500 € in the 1st -3. KJ, 2.000 € in the 1.-4. KJ, 2.500 € in the 1st-5th. KJ,
after that unlimited
not applicable in case of accident;
does not apply to prophylaxis (PRO)
€ 1,000 in the 1st KJ,
2,000 € in the 1st -2. KJ,
3.000 € in the 1.-3. KJ,
4.000 € in the 1.-4. KJ,
5,000 € in the 1st-5th KJ,
after that unlimited;
For dental treatment (ZB) and KfO ges .:
500 € in the 1st KJ,
1.000 € in the 1.-2. KJ,
1,500 € in the 1st -3. KJ, 2.000 € in the 1.-4. KJ, 2.500 € in the 1st-5th. KJ,
after that unlimited
not applicable in case of accident;
does not apply to prophylaxis (PRO)
EA 25
EA 30
EA 35
EA 40
EA 45
EA 50
EA 55
€ 23.90
€ 29.90
€ 29.90
€ 39.90
€ 39.90
€ 46.90
€ 18.90
22,90 €
22,90 €
€ 29.90
€ 29.90
34,90 €
€ 10.90
11,50 €
€ 11.50
€ 11.50
€ 11.50
€ 11.50
* After 5 years of precaution (GKV bonus booklet) the% rate increases
What costs does the GKV pay for dental treatment and replacement??
The statutory health insurance companies have long ceased to pay the full cost of dental treatment.
Takeover with dentures
For prosthetics, the GKV pays a fixed subsidy, depending on the findings, but regardless of the treatment chosen. The fixed subsidy for dentures was introduced in 2005, it is adjusted annually. There is a catalog with findings and the associated fixed subsidies.
The amount of the subsidy is about 50 percent of the cost of a simple standard care, this includes, for example, no inlays. The balance must be borne by the insured person. The insured person can in principle decide freely on the type of treatment >own bag .
Those who take regular precautions and have a complete bonus booklet will receive a higher fixed subsidy. That makes up 5 percent at 5 years, at 10 years it is 30 percent.
There is a hardship provision for insured persons with low incomes (up to € 1,106 gross) or insured who receive social benefits such as Hartz IV. You will receive twice the fixed allowance or at least the cost of the standard care will be reimbursed. Before the treatment, the insured person must submit a cure and cost plan prepared by the dentist to his health insurance company for approval.
Acceptance of treatments
The costs for treatments such as caries, root canal treatment, pulling teeth or necessary fillings in caries are covered by the SHI. Periodontal treatment and scaling is done once a year.
For fillings, however, only the costs for the cheapest material are taken over. Orthodontics is usually only taken up to the age of 18 years by the GKV.
The professional cleaning of teeth is not part of the scope of GKV – but some health insurance companies participate in the costs.
Dental treatment abroad
If a GKV insured person decides to have a dental treatment in another EU country, the SHI reimburses the costs of such treatment, which is also reimbursable in Germany to the extent that it would bear the costs of treatment in Germany.
Which tariffs are offered?
There is a wide selection of private dental insurance rates. Such a tariff is completed in addition to membership in the statutory health insurance. Due to the modular tariff structure you have it in your hand, which power range you want to secure.
Supplementary dental insurance – You should pay attention to this
Financial test shows what you should look for when taking a dental insurance. Please note the following tips:
- Test winners choose: Only high-performance tariffs reimburse high-quality materials such as inlays and implants. Good tariffs include the Dent Premium-U tariff of AXA, GIGA.dent Hallesche and EZ + EZT + EZP of HanseMerkur.
- Tariffs with standard care: Certain tariffs only reimburse the own contribution to the regular supply of the statutory funds. No insurance is really necessary for that. Only if several teeth are affected, it is worth concluding this supplementary insurance.
- Tariff change for contribution increases: Annoying are contribution increases for dental policies. In this case, a change of tariffs might make sense for your insurer. If the alternative tariff offers identical services, there is no exclusion or premium surcharge and no waiting times. In any case, a change of the insurer is unfavorable.
- Change insurance: There is a notice period of three months to the end of the insurance or calendar year. In addition, the minimum terms must be observed. A termination is not possible. Switching providers only makes sense if the new tariff offers higher benefits or a significantly lower contribution. However, the waiting time of eight months for dental treatment falls again. In addition, limited benefits apply in the first years of the contract.
Which services offer dental supplements?
The benefits of dental insurance are very different. Thus, not every insurer reimburses the costs for inlays. The same applies to the reimbursement rates. Some insurers pay 100 percent of the fixed allowance of the statutory health insurance funds, other tariffs provide for a 50 percent reimbursement of the total invoice amount.
The following services can provide high-performance dental supplements:
- Dental prophylaxis,
- Dentures (e.g., bridges, crowns, prostheses),
- inlays,
- orthodontics.
The tariffs for dental insurance, however, are partially opaque and complicated for laymen. It is important to compare the performance of each insurer.
What has to be considered in the supplementary dental insurance?
For dental insurance, you should note the following: For complex and expensive treatments (such as dentures or inlays), it is advisable to obtain a cure and cost plan from the dentist before the start of treatment. You present this to your insurance company for examination.
You should start treatment only after the insurer has approved the cost. If the health insurance has something to complain about on the dentist‘s expense report, you will be informed so that the treatment plan can be adjusted accordingly.
If you do not submit a treatment plan in advance of the treatment, the insurance may reduce or even deny you benefits.
Basically, the reimbursement amounts for dental treatment and dentures in the first years of insurance are limited. The insurer wants to avoid that someone insures against a favorable contribution and claims the same high benefits. This serves the protection of the insured community. One speaks in this case of the so-called total limit.
In addition, the apply special waiting times for dental services and orthodontics. According to the sample conditions of private health insurance, the special waiting period is eight months. However, the insurer may set shorter waiting times in its tariff provisions. In most cases, the waiting periods are waived if a current dental certificate is submitted at the beginning of the insurance.
Are there tariffs without waiting time and without health check??
To complete a private supplementary health insurance, you must complete a health examination. To do this, you must answer questions about your state of health in the application. The insurer wants to exclude that someone insured with pre-existing conditions and claimed benefits right at the start of the contract.
For this reason, there are no tariffs without health check. If a provider renounces the health issues, you should be skeptical of the tariff. Because the lack of risk selection premium increases are inevitable.
The waiting period is also intended to protect the community of insured persons. The private health insurance does not provide benefits until the general (three months) and the special waiting period (eight months) have been met. Does not mean other than that you pay contributions, but can not take the tariff yet. By the way: For dental supplements, the waiting period can be completely eliminated if you submit a positive dental certificate when applying.
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