What grants do the health insurance companies pay for professional teeth cleaning?
The essentials in brief:
- The grants are voluntary benefits provided by the health insurers and are therefore not the same everywhere.
- Some of these offers are part of an optional tariff or selective contract. This can be associated with a change of dentist.
- Statutory health insurance benefits are tartar removal once a year.
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What grants are there??
It is very different. Many statutory health insurance companies offer grants, but the amount and conditions vary. Grants of between 25 and 100 euros per tooth cleaning are possible. In some cases, health insurance companies also cover the full cost. However, this is subject to certain conditions, for example, it can only apply to tooth cleaning at certain dentists, for example from a network that cooperates with the health insurance fund. In some cases, the assumption of costs (in whole or in part) is limited to professional teeth cleaning per year.
The Federal Association of Statutory Health Insurance Dentists (KZBV) has been publishing a list of statutory health insurers that contribute to the costs since 2015. Depending on the tariff, private dental supplementary insurance also covers the costs.
Why do the health insurers not pay for professional teeth cleaning??
Professional tooth cleaning is not part of the statutory standard benefits of health insurance companies. To become a health insurer, dentists or health insurers would have to submit an application to the highest decision-making body, the Federal Joint Committee (G-BA). Then the benefits and economy would be checked. However, the health insurance companies can voluntarily provide benefits (so-called statutory benefits). Many also do this for reasons of insurance retention or customer recruitment. Only benefits that have already been checked and explicitly excluded as health insurance may not voluntarily pay health insurance companies. Statutory health insurance benefits for adults include a check-up twice a year and a tartar removal once a year, as well as early detection of periodontitis every two years.
What are the disadvantages??
Most statutory health insurance companies offer grants for professional tooth cleaning, but the type and scope vary widely. This makes it very confusing for insured persons, especially because payments are sometimes only possible in a selective contract or an optional tariff, the conditions of which should always be checked. When grants or reimbursements are tied to specific dental practices, patients give up their free choice of dentist. It is a question of whether the grant is worth a change of dentist. If you are unsure, you can contact your own health insurance provider to determine whether and under what conditions the costs will be covered in full or in part.
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