The bonus book for those insured by law
The bonus booklet is well known to everyone insured by law. It was introduced in 1989 to provide patients with an additional incentive for regular prophylaxis at the dentist. Annual check-ups help to identify and treat tooth damage as early as possible. If the bonus booklet is kept in a disciplined manner, patients can even save money in the event of expensive dental prosthesis care.
What is the bonus book?
The bonus booklet is a small leaflet and its format is comparable to that of a check card. So it can be conveniently stored in any wallet. The attending dentist documents the check-ups that have been carried out. If patients regularly take prophylaxis and can prove this with the help of the bonus booklet from the health insurance company, their entitlement to subsidies for dentures increases. 12- to 17-year-olds should have individual prophylaxis in every calendar half-year. From the age of 18, proof of a dental examination is only required once a year to increase the grant.
From whom does a patient receive his personal bonus book – dentist or health insurance? If you do not yet have a bonus booklet, you should simply ask your dentist about it the next time you visit. There everyone receives their personal document.
What do I need the bonus booklet for??
The bonus booklet demonstrably records how often someone was at the dental check-up. If a patient needs dentures, he can receive an increased cost subsidy from the health insurance company for regularly documented examinations. The amount of the grant depends on whether the bonus booklet has been run without gaps in recent years. The following applies to adults: go to a medical check-up once a year. Children and adolescents from twelve should use the appointments every six months. Patients without their own teeth also benefit from regular check-ups if they want to secure the grant.
Bonus booklet: How much is the grant??
A continuously maintained bonus booklet entitles patients to a grant for upcoming dentures. If the booklet was not kept in its entirety, half of the costs must be borne by yourself because the reimbursement of statutory health insurance for dentures without a bonus booklet is limited to 50 percent.
Anyone who has been through regular check-ups for five years will receive a 20 percent subsidy from their health insurance for the remaining share of the costs. If a complete bonus booklet can be presented over a period of at least ten years, the health insurance company pays an additional 30 percent. With a 20 percent grant, the total amount of the payment by the health insurance is 60 percent of the costs. If the eligibility for a grant is 30 percent, the total amount of the denture costs covered is 65 percent.
The year of treatment in which the denture is needed is not included in the invoice. If, for example, someone applies for a bridge pension in 2017, they will only receive the 20 percent co-payment for the fixed subsidy if the bonus booklet has been managed without gaps since 2012.
The hardship case regulation in the bonus booklet
If it is not possible for a patient to take over the personal contribution for his dentures, he can be largely exempted from it under certain circumstances. If this so-called "unreasonable burden" occurs, the legally insured person falls under the hardship case regulation. This applies, for example, to groups of people with low income, recipients of certain social benefits or students who receive BaFöG. You may then receive double fixed allowance for regular dental prosthesis from your health insurance. The bonus book does not have to be kept in full.
Even in the toughest case dentures – when does that apply?
If the gross monthly income for living, including the income of relatives living in the same household, such as spouse, partner, minor and adult but family-insured children, do not exceed the following income limits:
for single persons: 1,190 euros, with a relative: 1,636.25 euros, for each additional family member additionally: 297.50 euros. (The data refer to 2017.)
A so-called "sliding hardship case regulation" exists if the income is slightly above this. Limits. The statutory health insurance fund can then reimburse the amount by which the simple fixed subsidies – without bonus – exceed three times the difference between the gross monthly income for living expenses and the income limit (“hardship case limit”) which is decisive for granting the double fixed subsidy. This additional cost sharing is a maximum of an amount that includes the double fixed grants and no more than the costs actually incurred (§ 55 Paragraph 3 SGB V). The insured person must bear the remaining costs themselves.
Who runs my bonus book?
Every person insured by law can decide whether to keep a bonus book or not. If you do not do this, you are giving away possible grants for dentures. The bonus booklet is usually owned by the patient. During the annual or semi-annual check-up, the dentist documents every prophylaxis that has taken place. Regular visits to the dentist help to ensure long-term health of the teeth.
What to do if a stamp is missing from the dentist bonus booklet?
If the dentist’s stamp is forgotten in the bonus booklet, it can be added easily. Provided, of course, that the appointment was actually made. Adults should have teeth and teeth examined once a year, children and adolescents from the age of twelve twice a year. The checks that have been carried out are then confirmed in the bonus booklet. Each patient is responsible for his bonus booklet and should present it to the dentist for registration.
Those who miss their annual or semi-annual visit to the dentist will then miss the stamp in the bonus booklet. The benefits of possible grants are accordingly eliminated. Then the bonus booklet must be documented regularly for at least five years before the application for a denture grant can be applied for again.
What to do if the bonus book cannot be found?
If the bonus booklet is lost, the treating dentist can easily check the previous appointments in the patient file and enter it in a new bonus booklet. It is best to keep it at home in a fixed place where it is easy to find.
What happens when you change dentists??
The change of dentist has no influence on the validity of the bonus book. Patients simply bring their bonus booklet to the new dentist, who then continues with the documentation as before. Of course, you can also have a new bonus book issued. In the case of a denture to be applied for, the old bonus booklet must then be submitted to the health insurance company. It is important to document the inspection appointments from the past five or ten years completely.
The bonus booklet is also available for children?
At the age of 12, children also receive their personal bonus book. Up to the age of 18 they should have their six-monthly check-ups confirmed at the dentist. From then on, only one check-up per year needs to be documented. Regular maintenance of the bonus booklet is also helpful in paying early attention to dental health. Anyone who permanently integrates the visit to the dentist into the annual plan ensures that teeth are healthy and aesthetic. Should dentures nevertheless become necessary, the health insurance will subsidize them in the same amount for children and adolescents as for adults. Regular visits to the dentist and their complete documentation in the bonus booklet are therefore worth cash.
Not just because of the dentist bonus
Keeping your bonus book regularly should be a matter of course for everyone insured by law. The health insurance grants for dentures are a high motivation. But not only the financial benefits should be the main focus for the annual visits to the dentist. Because what your own teeth are worth, you often only notice when it’s too late. Therefore, keeping the teeth healthy is an important contribution to a good quality of life. The dentist can only repair damage discovered early enough. Annual or semi-annual check-ups help you to take responsibility for your teeth and teeth.
Tooth co-payments despite bonus book
About 60 percent of those insured under statutory health insurance are not entitled to a bonus for their dentures because they have not documented the evidence of the check-ups in the bonus booklet or only documented it irregularly. The 20 or 30 percent subsidy from the health insurance companies is then no longer applicable. Even if you no longer have your own teeth and are wearing a full denture, you should go to dental care, because this is the only way to secure the subsidy.
Even patients who have fully documented their dentist visits have to pay for their dentures, a bridge, prosthesis, etc. It is therefore advisable to take out private dental supplement insurance in good time.
If you want to be on the safe side, choose DFV-ZahnSchutz Exklusiv 100. As the test winner among 234 additional dental insurance policies tested by Stiftung Warentest Finanztest (05/2019), the high-performance dental tariff of the Deutsche Familienversicherung received the top grade VERY GOOD (0.5).
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