The significance of children's dental supplementary insurance: a brief analysis.
In the realm of children's dental care, understanding the differences between statutory health insurance (SHI) and dental supplementary insurance is crucial. While SHI provides essential coverage, a supplementary insurance plan can offer broader orthodontic coverage with fewer restrictions.
Orthodontic Coverage
Statutory health insurance primarily covers medically necessary orthodontic treatments for children up to the age of 18, only for severe cases (KIG 3-5). Cosmetic corrections are typically not included. In contrast, dental supplementary insurance covers a wider range of orthodontic treatments, including cosmetic corrections and premium options like ceramic or lingual braces.
Costs
Parents with SHI usually bear the initial 20% co-payment for treatments in KIG 3-5, which is reimbursed after treatment completion. Dental supplementary insurance, on the other hand, requires monthly premiums and may have waiting periods, but out-of-pocket costs are limited to deductibles before reimbursement.
Additional Dental Services
SHI covers basic dental check-ups and necessary treatments, with limited coverage for professional cleanings or premium materials. Dental supplementary insurance, however, offers enhanced coverage, including professional cleanings, premium fillings, crowns, implants, and cosmetic dental procedures.
Waiting Periods and Restrictions
SHI has no waiting periods for benefits, but eligibility rules apply, such as age limits and severity. Dental supplementary insurance may have waiting periods up to 8 months, and benefits vary, requiring careful tariff comparison.
Covered Treatments
Dental supplementary insurance should cover a range of treatments for children, including fissure sealing, dental cleanings, dental fillings, root and periodontitis treatments, and dental prosthetics.
Timing is Key
Taking out dental supplementary insurance early prevents exclusions and ensures full coverage for your child. The deadline for insurance is typically between 3 to 4 years. It's too late to take out insurance if a classification into a KIG category has already been made.
Cost Considerations
The costs for orthodontic treatment can quickly run into the thousands. For mild to severe malocclusions (KIG 3-5), the health insurance coverage is usually sufficient. However, for less severe malocclusions (OIG 1 and 2), the statutory health insurance does not cover the costs.
In conclusion, choosing between statutory health insurance and dental supplementary insurance for children depends on the expected need for orthodontic care beyond basic statutory coverage and willingness to pay extra for broader benefits.
References
[1] British Orthodontic Society. (2021). Classification of Malocclusions. [online] Available at: https://bos.org.uk/classification-of-malocclusions/
[2] Dental Defence Union. (2021). Dental Supplementary Insurance for Children: What You Need to Know. [online] Available at: https://www.ddu.co.uk/knowledge-centre/dental-supplementary-insurance-for-children
[3] NHS. (2021). Orthodontics for Children. [online] Available at: https://www.nhs.uk/conditions/orthodontics-for-children/
[4] Denplan. (2021). Dental Insurance for Children. [online] Available at: https://www.denplan.co.uk/dental-insurance/dental-insurance-for-children/
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