Test Which additional dental insurance is worthwhile

Stiftung Warentest: When is additional insurance for dentures really worthwhile?

04/17/2012

Since the beginning of the year, the fee schedule for dentists (GOZ) applies. High-quality dentures become more expensive. According to estimates by the black and yellow federal government, dentists will incur about 345 million euros more in fees this year. The Stiftung Warentest has taken some additional insurance for dentures closer scrutinized and explains when such insurance at all comes into question and how the individual providers cut off.

Christian B. wants to finally get rid of his old amalgam fillings and replace them with an inlay. Finally, due to the high mercury content, amalgam is suspected of being hazardous to health. Then the dentist calculates his activity under the new fee schedule for dentists. Including the costs for the laboratory, the dentist will give the patient an invoice of 650 euros. When Christian B. files the costs with the health insurance company, she only took over 46.00 Euros. The rest had to be paid by Mr. B. himself. „Had I known about the high costs that I now have to pay on my own, I would certainly have rethought the treatment.“

Few suppliers cut with „very well“ from
There are only two alternatives for such situations. Either the patient retains the amalgam filling or he wisely signs an additional policy. But according to Stiftung Warentest, such additional insurance is only worthwhile for consumers who do not want to limit their dentures to more cost-effective therapies. But the offer is great and hard to miss. The magazine alone „Finanztest“ The goods tester has compared a total of 147 tariff offers from various insurance companies. The testers have often found significant differences between tariffs and providers. As a result, only 33 additional insurances were rated „very well“ received. On the other hand, 23 tariffs got the predicate „sufficient“. The rest cut with „Well“ or „satisfying“ from.

The best take over expensive dentures
The best assessed policies pay also very elaborate dentures with fee payments of 3000 euros. However, the insurers do not cover the entire costs, but only up to an amount of 2300 euros. Who has no additional insurance, can expect a maximum of about 387 euros from the statutory health insurance. According to the test verdict, most dental prostheses offer the tariff options ZEVp + ZEH + ZIV of Deutsche Familien Versicherung (DFV) as well as ZAB + ZAE + ZBB and ZAB + ZAE + ZBB + ZBE, which are offered by Neckermann and Ergo Direkt Versicherung in the same way.

Who pushes on such luxurious dentures, must pay a lot for the additional policy. For example, tariff offers cost 33 euros a month for a 43-year-old policyholder. The older the insured, the higher the prices. A 73-year-old then pays over 40 euros per month.

Also favorable offers reached good ratings
Four cheaper offers also reached the mark in the analysis „very well“. These are the tariffs EZ + EZT of the HanseMerkur and central.prodent of Central as well as DT85 of DKV and ZZ Premium Plus of Huk-Coburg. All tariffs cost up to 25 euros per month if the policyholder is about 40 years old.

However, it is even cheaper, as shown by the tariffs of vitaZ3 Central, Allianz ZahnPlus and HanseMerkur EZ + EZE. Although these insurance companies do not pay that much, they still perform relatively well in the tests. According to Stiftung Warentest, these policies are already available for eight euros. The most expensive in this segment costs 15 euros per month for a 43-year-old.

Price does not always say something about benefits
The price alone does not determine the quality of the dental insurance, as the test showed. The policy of Gothaer (tariff ZEG + MediProphy) costs only 17 euros. However, the performance did not fare well in the comparative study and was reported by the newspaper „Finanztest“ only with one „sufficient“ graded. For example, no reimbursement is made for inlays and implants, the testers report.

Denture insurance does not always pay
If the dentist has already discovered teeth that require treatment, the insurance will not pay if it has been completed after the diagnosis has been made. Insured persons must wait at least eight months after the insurance has been taken out before they can pay for the costs of dentures on a pro rata basis. In addition, depending on the contract in the first years after the conclusion of the policy, the benefits are usually limited. This is how the insurance companies secure themselves so that they are not only used in acute cases of treatment. Therefore, first one „To take out insurance and then wait for a contract to be accepted by contract“.

Even those who already have an additional policy, should check before using a dental prosthesis, whether the contract terms are still effective. The expert Holger Rohde of "Finanztest" advises therefore, for the subsequent examination of the contracts. Sometimes, a change may be worthwhile, as older rates in some cases „An old insurance can be terminated at the end of the minimum term, which is usually two years, with a notice period of three months to the end of the insurance year Since the insured person does not receive any dental care from a new tariff, consumers should wait and see whether the new provider also agrees to a reception, otherwise it may not be covered by the policy anymore.

Beware of advertising promises
The insurance providers advertise with high rates of reimbursement. Potential policyholders should join „do not be blinded by it“, reminds Rohde. According to the expert, the provider Axa advertises to reimburse its customers 100 percent. On closer inspection, the 100 percent only come about because the subsidy from the health insurance is calculated from the standard care. This means that if 3000 euros for an implant due, the insurance pays only 387 euros. In this amount, the health insurance pays a subsidy. The remainder must pay the insured despite dental insurance itself. All other test results and judgments can be read in the new issue of the magazine Test. (Sb)

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Picture: Claudia Heck