Of course, the price and the reimbursement amount play an important role in your decision for or against a certain plan. However, the most important thing is this: top-up dental insurance only makes sense if it is available when you need it. Unfortunately, there are many ways in which insurance companies can attempt to evade their responsibilities. Therefore, when taking out top-up dental insurance, you should pay particular attention to gaps in coverage. Here at ottonova, we prefer open and transparent communication. Therefore, we don't use long, overcomplicated sentences. We will tell you clearly what we do and don't cover. For you, this means quite simply: we keep our promises.
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We have selected two examples of what such loopholes may look like.
Example 1: Orthodontics for children
The plan states that the top-up insurance will pay if:
- The treatment starts before the age of 18,
- Public health insurance does not cover it, and
- The treatment is medically necessary.
However, these conditions never occur together. Because if the treatment is medically necessary for children, public health insurance will always pay at least a part. Therefore, in these cases, top-up insurance never pays out.
Example 2: Root canal treatments, periodontal treatments, and occlusal splints
The plan states: Root canal treatments, periodontal treatments, and occlusal splints are not reimbursed if public health insurance covers them.
In all three cases, the patient may need to pay for useful additional services, such as:
- Use of electric tools and chemicals to clean and disinfect root canals, or use of a surgical microscope for root canal treatments;
- Instructions for proper oral hygiene and, in certain cases, tartar removal or professional teeth cleaning in the context of periodontal treatment;
- High-quality occlusal splints.
Since public health insurance covers a part of the costs in all the above-mentioned cases, top-up insurance funds do not need to cover these additional benefits. However, that is exactly what patients expect from top-up dental insurance.
