BILD clarifies questions about the dental bonus booklet
The year is coming to an end and the Christmas stress is drowning many things that have to be done this year. Among other things also whether one had already the dental control for the bonus booklet in this year. Because who forgets once the stamp, starts again from the beginning.
BILD and dental expert Kai Fortelka from the Federal Association of Statutory Health Insurance Dentists clarifies the most important questions about the bonus booklet.
What is a dental bonus booklet?
Insured persons in the statutory health insurance must pay a not inconsiderable part of their dental prosthesis themselves. This includes bridges, crowns, implants and prostheses. If you want to reduce your own costs, you must regularly keep a bonus booklet. This means having your teeth checked regularly. Because if gums and teeth are treated in good time, dental prostheses can often be avoided.
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How often do I have to check?
Once a year adults go for a check and have this confirmed with a stamp in their notebook. Children and teenagers have to go twice. In their case, regular prophylaxis is added to the check-up. Among other things, children are explained how to brush their teeth properly and the teeth are sealed.
How much remission do you get?
The rules on fixed subsidies are laid down by the health insurance funds and dentists. For example, if a tooth is fully crowned, the health insurance company assumes that a metal crown is sufficient in the back jaw area. In principle, an adult receives 50 percent replacement for this dental prosthesis. Only if regular examinations by the dentist over a period of five years are proven to be complete will the fixed subsidy for the dental prosthesis increase to 60 percent. If these control examinations can even be proven over a period of 10 years, the health insurance subsidy is increased to 65 percent. Children and adolescents under the age of 18 do not have to pay anything.
If kids don’t pay anything extra, why would my kid go to the controls?
On the one hand, the milk teeth must be checked regularly in order to prevent possible caries damage to the permanent teeth. When the permanent teeth come, they are immediately sealed, which greatly reduces the susceptibility to subsequent caries attack. The bonus booklet should be kept at the age of eight at the latest, as the child must pay extra from the age of 18 and thus receives the full bonus.
Exactly how much do I get?
The statutory funds only cover the costs of standard care. All other costs are to be borne by the patient. For example, the cost of a fully veneered crown in the anterior region can be around 600 euros. The health insurance company pays a fixed subsidy of 183 euros. This results in an own contribution of 417 euros for the patient. If the booklet is maintained for ten years, this results in an own contribution of 362 euros. This results in a saving of 55 euros.
What if I lose my bonus booklet or have forgotten a stamp?
Once the dental check has been carried out, the stamp can be easily inserted by the dentist. If you lose your bonus booklet, you can have the controls added to a new booklet with a little extra effort. However, if you have forgotten the checkup and haven’t been to the dentist for a year, you can start all over again with the bonus booklet.
How can I still reduce my own contribution?
The statutory health insurances already offer supplementary insurances from nine euros and with many private health insurances you can reduce your own contribution almost to zero. It depends simply on how high the monthly contribution is. For low-income earners, the costs of standard care are completely covered by the health insurance. The current hardship limit for a person at the AOK is a monthly gross income of 1106 euros. However, if you are just above this limit, you can still apply for a subsidy from your health insurance company.
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