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Old 20.03.2015, 04:12
Posts: n/a
Re: Dental insurance

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I am insured by Assura and I am considering to get their additional dental insurance (denta plus) for 20 CHF / month.

It seems that they cover everything up to 15k per year:

Does that really mean that anything that happens (root kanal, filling, checkup) is covered by the insurance? That seems too good to be true.

It is recommended that one go to 2 dental hygienist checkups per year - meaning that you should spend 300-400chf just on prophylaxis every year.

If you can get in (your teeth are in perfect health and you know that you could get into dental trouble in later years - look at your relatives to compare), calculate yearly cost you'd run into without insurance, like

- 2 dental hygienist visits
- 1 cavity filling
- half a root canal (if you think you're likely to have one every other year)
- a large-ish dental problem every 5 years

Add that up and then think if you'd rather spend 240chf/year on insurance or wait until the bad things happen and end up paying 100% out of your own pocket - plus CHF 300-400 per year for the dental hygienist. Meaning that you should weigh CHF 540-640 a year (plus the cost not covered by this insurance, see below) against the possible maximum which could be incurred if your worst dental nightmare were to come true without insurance.

With insurance, if nothing happens, you'll have blown the money you could've spent on 1.5 dental checkups on your insurance premiums.
If something happens with insurance, you'll be shelling out part of the cost along with your premiums.
If something happens without insurance and you're billed several grand - well, good luck.

In short - make sure you know how high the coverage amount is and which exclusions apply before signing up. To be able to do this, I recommend getting all the insurance info you can in your native language and calling Assura to clarify your questions (in writing, if they make verbal assurances which aren't clearly written in the documents given to you).

Details of the insurance accessible on the net are here but there will probably be more detailed info which you should inquire about.
In short (from the way I interpret the text, not being affiliated with that company in any way):
- outpatient checkups and therapeutic measures: Coverage of max. 80% of CHF 15k per year, after payment of a franchise of CHF 500/250
- orthodontic treatments: CHF 500 per year, maximum paid are CHF 10'000.- over multiple insurance periods. Assura covers 80% of the insured payments. Payments only covered up to the 20th year of age.
- dental crowns etc.: Coverage of 80% of payments, maximum CHF 1k/year
- prevention (dental hygienist and removal of tartar) 80.-/year after the 2nd year, no franchise/deductible

So from what I understand, 15k*80% minus CHF 250/500 of outpatient treatments are covered, orthodontic treatment is not covered (assuming that you're older than 20?), crowns etc. costing more than 1k aren't covered in full and you have to pay for 3/4 of your dental hygienist appointments out of pocket assuming that they cost CHF 160 per dental cleaning and that you go twice per year.

Again: I do not guarantee in any way that this info is correct or complete.

Last edited by glowjupiter; 20.03.2015 at 06:18.
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