Stiftung Warentest: When additional insurance for dentures is really worthwhile
The fee schedule for dentists (GOZ) has been in effect since the beginning of the year. High quality dentures are becoming more expensive. According to estimates by the black and yellow federal government, dentists will receive about 345 million euros more in fees this year. The Stiftung Warentest took a closer look at some supplementary insurance for dentures and explained when such insurance could be considered and how the individual providers performed.
Christian B. finally wants to get rid of his old amalgam fillings and replace them with an inlay. After all, amalgam is suspected of being a health hazard due to the high mercury content. The dentist then calculates his work according to the new fee schedule for dentists. Including the costs for the laboratory, the dentist presents the patient with an invoice of 650 euros. When Christian B. submitted the costs to the health insurance company, they only took over 46.00 euros. Mr. B. had to pay the rest himself. "If I had known about the high costs that I now have to pay alone, I would have reconsidered the treatment."
Few providers rated "very good" There are only two alternatives for such situations. Either the patient keeps the amalgam filling or he wisely concludes an additional policy. However, according to Stiftung Warentest, such additional insurance is only worthwhile for consumers who do not want to limit their dentures to cheaper therapies. But the offer is large and hard to miss. The “Finanztest” magazine of the goods testers alone compared a total of 147 tariff offers from various insurance companies. The testers often found significant differences between tariffs and providers. The result showed that only 33 supplementary insurances were rated "very good". 23 tariffs, on the other hand, were rated “sufficient”. The rest of them scored “good” or “satisfactory”.
The best also take care of expensive denture treatments. The best-rated policies also pay for very expensive 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. If you do not have additional insurance, you can expect a maximum additional payment of about 387 euros from the statutory health insurance companies. According to the test verdict, most denture services offer the tariff options ZEVp + ZEH + ZIV of the Deutsche Familien Versicherung (DFV) as well as ZAB + ZAE + ZBB and ZAB + ZAE + ZBB + ZBE, which are offered in the same way by the Neckermann Group and Ergo Direkt Versicherung .
Those who insist on such luxurious dentures also have to pay a lot for the additional policy. For example, the tariff offers cost a good 33 euros per month for a 43-year-old policyholder. The older the insured becomes, the higher the prices rise. A 73-year-old then pays over 40 euros a month.
Cheap offers also achieved good ratings Four cheaper offers also achieved a "very good" rating in the analysis. These are the tariffs EZ + EZT from HanseMerkur and central.prodent from Central as well as DT85 from DKV and ZZ Premium Plus from Huk-Coburg. All tariffs cost up to 25 euros per month if the policyholder is around 40 years old.
However, it is even cheaper, as the vitaZ3 tariffs of Central, Allianz ZahnPlus and HanseMerkur EZ + EZE show. Although these insurance companies do not pay as much, they still do relatively well in the tests. According to the Stiftung Warentest, the policies mentioned 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 anything about benefits The price alone does not determine the quality of the dental insurance, as the test showed. The Gothaer policy (ZEG + MediProphy tariff) costs only 17 euros. However, the performance did not do so well in the comparative study and was only rated "sufficient" by the newspaper "Finanztest". For example, the inlays and implants are not reimbursed, the testers report.
Denture insurance does not always pay If the dentist has already found teeth that require treatment, the insurance does not pay if they have only been concluded after the diagnosis has been made. Insured persons must wait at least eight months after taking out insurance until they cover the costs of a denture proportionately. In addition, depending on the contract, benefits are usually limited in the first years after the policy has been concluded. In this way, the insurance groups protect themselves so that they are not only used in acute treatment cases. Therefore, it is important to "take out insurance first and then wait a while until a takeover is permitted under contract law".
Even if you already have an additional policy, you should check whether the contractual terms still apply before using a denture service. The expert Holger Rohde from "Finanztest" therefore advises to check the contracts afterwards. Sometimes a change can be worthwhile, since older tariffs in some cases provide "significantly less than the new offers from insurers". An old insurance company can give three months' notice after the end of the minimum term, which is usually two years, at the end of the insurance year However, you should refrain from switching during ongoing treatments, as the insured person will not be able to get a denture benefit from a new tariff. Before canceling, consumers should definitely wait and see whether the new provider also agrees to an admission that there is no longer any insurance cover because there is no longer a policy.
Beware of advertising promises Insurance providers advertise their reimbursements with high quotas. Potential policyholders should “not be blinded by this,” warns Rohde. According to the expert, the provider Axa advertises that it will refund its customers 100 percent. The 100 percent only comes into being after a precise check because the health insurance subsidy is calculated from the standard care. This means that if 3000 euros are due for an implant, the insurance will only pay 387 euros. The health insurance company also pays a subsidy in this amount. The insured person has to pay the rest himself despite denture insurance. All other test results and judgments can be read in the new edition of the magazine Test. (sb)
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