swissmom: Why should parents take out supplementary insurance to partially cover the costs of orthodontic treatment?
Claudia Bruckert: The demands to have harmonious, aesthetic interlocking are high today. Through the annual school dental check-ups, parents become aware that treatment might be necessary. There is not exactly any pressure, but there is a high demand in the aesthetic area. About half of the tooth corrections are functionally necessary, the other corrections are aesthetically justified. The supplementary insurance covers part of the costs of these desirable corrections; in really difficult cases with a medical background, the costs are partly covered by the IV or the basic insurance. In the case of accidents, the costs are borne by the accident insurance.
swissmom: When is the right time to take out such supplementary insurance?
Claudia Bruckert: As early as possible. We even recommend that parents do this at birth when they take out insurance for the child. The premium is often free for children under the age of five.
swissmom: Why take out this insurance so early?
Claudia Bruckert: Up to the age of 4, you can take out such supplementary insurance with most insurance companies without a dental certificate. At a later date, the insurance companies require a dental examination and it often happens that a child is no longer admitted because it appears that a correction may be necessary at a later date.
Dr. Claudia Bruckert is a specialist in orthodontics. She was a senior physician at the University of Zurich for 4 years in the Department of Orthodontics, specialising in the training of students and the care of children with cleft lips, jaws and palates. Since 2011 she has had a practice for orthodontics in the city of Lucerne.
swissmom: What are the chances of being able to take out insurance at a later date?
Claudia Bruckert: Insurance companies are very strict when changing health insurance companies. If a child falls out of the supplementary insurance, it is hardly taken up by another insurance. If it does, there is hardly any maximum coverage. If you have taken out the insurance for the child in infancy and do not need it later, you have paid a little too much, but if it comes to a treatment, the costs for the better coverage have been worthwhile in any case.
swissmom: What services are generally provided? What costs do parents have to pay themselves?
Claudia Bruckert: That depends on the insurance model and the insurer. As a rule, 50 to 75% of the costs are covered, but there are also insurers who cover 100% of the costs. Some insurers pay a certain amount each year. It is worth taking a very close look at which benefits are included in the insurance policy, because sometimes basic insurance up to the age of 18 also covers part of the costs for orthodontic treatment. Since not everything is always clear, you should personally ask the insurance company which costs will be covered.
swissmom: One hears again and again from parents who complain that the health insurance company has not paid as much as expected. What should you pay particular attention to when taking out insurance? Where are the pitfalls lurking that are often ignored beforehand?
Claudia Bruckert: Before taking out insurance, it is worthwhile to request in writing the exact details of which costs will be covered. But you should also remember that over the years the conditions can change and cover suddenly ceases to apply. The insurance companies will inform you of these changes, but this is easy to overlook. Parents should therefore become active and ask, because if one has tacitly accepted a change, hardly anything can be done any more. With the orthodontist, they should take a close look at the treatment plan and the cost estimate and also demand this information in writing. If, for example, the insurance covers a certain amount annually, it makes sense to divide the treatment over several years. The tariff of points is also important, because the insurance often only covers a tariff of Fr. 3.10, but the orthodontist works at a higher tariff. The better the parents are informed, the better the interaction works. One must absolutely dare to inquire before the treatment exactly and to catch up possibly a second opinion.
swissmom: What can parents do who have failed to take out supplementary insurance in good time?
Claudia Bruckert: In this case, the orthodontist has to check with the parents which treatments are urgent and sensible and what one can possibly wait with. Most parents regret having missed the opportunity to take out supplementary insurance on time. Supplementary insurance for orthodontic treatment is relatively cheap and worthwhile in relation to the costs that will be covered later. Supplementary insurances, which cover all dental treatments, for example caries treatments, are much more expensive. I would only recommend insurance that covers the entire dental treatment spectrum if a child has motor and health problems for which normal oral hygiene is not possible, because these insurances are very expensive in relation to the costs that are covered.
swissmom: What should parents take into account in connection with a change of insurance?
Claudia Bruckert: Here, too, one should inform oneself well and consider very carefully whether a change makes sense, especially during an ongoing treatment. In this case, we recommend that parents who have good coverage for orthodontic treatment do not make a change, at least for the child in question. It is not realistic to get a better offer from another insurance company during the treatment. In the best case, you will get the same coverage, but certainly not a better one.