Categories
English Insurance Swiss

Pro and contra of a dental insurance 

Regardless of your age, dental insurance that covers at least part of the preventive costs seems to be a good solution.

Dental care can be an important part of a budget. In view of the sometimes very high costs associated with dental care at all ages (orthodontics at an early age and major operations at an advanced age), this article first deals with the generalities on regular dental care applicable to all and then with the specific situation in Switzerland. As dental care is not reimbursed by the basic health insurance system in Switzerland, except in the case of accidents and as the coverage, if granted, varies greatly, some generic situations and options will be proposed for children, youth and older adults.

Regular dental care and check-ups

Dental hygiene

If you have good oral hygiene habits and a healthy mouth, your dentist and dental hygienist will probably suggest professional teeth cleaning about twice a year. Six months between visits is a conservative interval to detect potential dental health problems before they develop into something more serious. If there are pre-existing problems, three or more visits per year will be necessary. Most people without dental problems will be satisfied with one or two annual cleaning.

X-Ray

Unfortunately, superficial cleanings and reviews often fail to detect cavities under existing repairs or hidden cracks. If you have not had cavities or other oral health problems, you probably will not need x-rays at every visit. However, patients with less stable dental health will need more frequent x-rays so that their dentist can monitor progress. For example, a general x-ray every 2-3 years and specific x-rays of at-risk areas every year may be recommended. If your mouth is healthy and free of problems such as gum disease and tooth decay, an annual x-ray is probably not necessary. However, for adults with many fillings, crowns, bridges or other restorations, x-rays help the dentist find cavities under your fillings and crowns or in new places.

The interval between x-rays is determined by the rate at which cavities develop. In general, it takes about two years or more for cavities to penetrate the enamel of adult teeth. The rate is faster in children, which is why the recommended intervals between x-rays are shorter for them.

Dental insurance in Switzerland

Dental coverage

Unlike many other countries, Switzerland does not include dental coverage in its mandatory health insurance. Compulsory health insurance covers damage to teeth only in rare cases of total dental catastrophe.

Most major Swiss health insurance companies do offer dental insurance. Some offer it as a stand-alone insurance. Others only allow you to purchase dental insurance in combination with their health insurance policies, like Concordia for example.

In general, dental insurance covers dental treatment and dental laboratory fees. Some policies also cover preventive check-ups. Purely cosmetic procedures are not normally covered and orthodontics are subject to strict age limitations.

In general, dental insurance pays a flat fee of CHF 50-150 or 100% of preventive care – examinations, x-rays and cleanings. In contrast, basic procedures such as fillings, root canals and extractions are only covered at 50-80%, while major procedures such as crowns, bridges, implants and treatment of gum disease are sometimes only covered at 50%.

Insurers only cover treatments performed by Swiss dentists, but some insurers such as Assura cover dentists just accross the border and Helsana covers dentists outside of Switzerland as long as the amounts charged are less than the equivalent treatment in Switzerland.

Exact coverage varies between dental insurance policies. It is important to check carefully what costs are covered and what your needs are before choosing a policy.

Dental insurance options to consider for children

For children, we recommend coverage from an early age, so no questionnaires will be required for dental treatment and dental laboratory fees, and expensive orthodontic treatment can be covered. An interesting comparison for orthodontic treatment for children, even though the data is limited and the premiums change, is available under “«Kassensturz»-Test – Enorme Unterschiede bei Zahnspangen-Versicherungen – Kassensturz Espresso – SRF in German. The best are Helsana, Swica and CSS, followed by Assura and Sanitas. If you change your dental insurance, you may lose benefits due to “pre-existing circumstances”. This is not the case if the dental insurance is still with the same company. So be sure to check which orthodontic treatments will or will not be covered under the new insurance, especially if you have previously accumulated a budget for care. In principle, we cannot recommend a change of insurer for children, since any bonuses accumulated may be lost. Instead, consider a change after orthodontic treatment has been completed or when the accumulated budget has been used up.

Best dental insurance options for adults

For adults with healthy mouths, it is questionable whether expensive coverage is worth it. In general, dental insurance can be a good way for everyone to cover preventive costs or larger amounts in case of future deterioration. Examples are Helsana covering up to CHF 2,000 of care including dental hygiene and check-ups in its intermediate plan (Silver) or Sanitas dental basic which covers up to 2,000, including only CHF 100 for check-ups and scaling. Sanitas dental basic does not require a dental certificate in its basic plan. The offers of Atupri, Assura, Swica, ÖKK, Mutuel, CSS and Visana appear to be more expensive for the same or lesser coverage and are therefore not recommendable.

Dental insurance for adults over 50

For adults over 50 years of age or who have already undergone major operations, good coverage is generally impossible to achieve as the insurance company often refuses individuals over this age. Dental insurance that covers at least part of the preventive costs seems to be a good solution. It disciplines the patient to have regular check-ups with the dental hygienist and the dental doctor. Generally, the older you are, the less likely you are to get dental insurance. A sound option is Helsana Light which covers a maximum of CHF 300 per year only but can have a disciplining effect on check-ups and dental hygiene.

In summary

In order to limit the time wasted in taking steps, ask for offers from Helsana, CSS, Swica, Sanitas and Assura. for children, from Sanitas and Helsana for adults and consider a minimum coverage with Helsana from the age of 50 onwards in order to encourage you to make regular check-ups.