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06.08.2021, 15:07
| Member | | Join Date: Jul 2015 Location: Zurich
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| | Preexisting conditions - dental insurance
I would like to change the health insurance plan for my daughter (7).
She is currently covered with dental insurance for orthodontics (since she was born).
How do pre-existing conditions work for orthodontics? What happens if in 3 years she needs braces? Can the new insurer claim that her teeth needed straightening since before we switched plans? It's technically true, I guess, as her mouth shape is clearly the same she has now. But no dentist has said anything about her teeth yet.
Once they accept us, can I be relatively confident that she will be covered?
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06.08.2021, 15:12
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | I would like to change the health insurance plan for my daughter (7).
She is currently covered with dental insurance for orthodontics (since she was born).
How do pre-existing conditions work for orthodontics? What happens if in 3 years she needs braces? Can the new insurer claim that her teeth needed straightening since before we switched plans? It's technically true, I guess, as her mouth shape is clearly the same she has now. But no dentist has said anything about her teeth yet.
Once they accept us, can I be relatively confident that she will be covered? | | | | | If you Switch plans to a new insures they will not cover pre existing conditions. If you lower your coverage you will be able to swap plans with the existing insurer, if you raise cover they will limit to the old cover limits on pre existing.
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18.08.2021, 18:34
| Forum Veteran | | Join Date: Feb 2008 Location: Zürich
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | I would like to change the health insurance plan for my daughter (7).
She is currently covered with dental insurance for orthodontics (since she was born).
How do pre-existing conditions work for orthodontics? What happens if in 3 years she needs braces? Can the new insurer claim that her teeth needed straightening since before we switched plans? It's technically true, I guess, as her mouth shape is clearly the same she has now. But no dentist has said anything about her teeth yet.
Once they accept us, can I be relatively confident that she will be covered? | | | | | At age 7, it will most definitely be required by the new dental insurer that your daughter gets a dental exam before they'd accept her. If they accept her, you will see exactly in the policy whether anything is excluded (pre-existing conditions). In any event, you should only cancel the existing one after signed contract with the new insurer. So just go ahead and apply to the new one and see how it goes.
Once the new company accepts her, unless it's mentioned anything is excluded, she'll be covered per the coverage and waiting period.
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18.08.2021, 21:00
|  | Forum Legend | | Join Date: Nov 2007 Location: Switzerland
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | I would like to change the health insurance plan for my daughter (7).
She is currently covered with dental insurance for orthodontics (since she was born).
How do pre-existing conditions work for orthodontics? What happens if in 3 years she needs braces? Can the new insurer claim that her teeth needed straightening since before we switched plans? It's technically true, I guess, as her mouth shape is clearly the same she has now. But no dentist has said anything about her teeth yet.
Once they accept us, can I be relatively confident that she will be covered? | | | | | I would keep the dental where it is until later and avoid any risk and change only the other plans now.
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19.08.2021, 07:57
| Forum Veteran | | Join Date: Sep 2009 Location: ZH
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| | Re: Preexisting conditions - dental insurance
I would suggest you get an appointment with a qualified orthodontist to determine if your daughter is a possible candidate for orthodontic treatment BEFORE changing her insurance. I understand she is only 7, but her spacing, jaw structure, bite ( occlusion) and existent adult dentition is visible. ( need a panoramic x-ray)
Be careful to choose a SSO Kieferorthopäde and NOT some charlatan offering Invisalign. ( Many dentists take a weekend course and buy the scanner to add this to their repertoire)
In Zürich, Dr. Barbara Jaeger is a serious professional and compassionate person.
In Luzern, Dr. Yann Deleurant is fabulous. https://www.swissortho.ch/
Last edited by arrow; 19.08.2021 at 08:35.
Reason: Typo
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19.08.2021, 08:29
| Forum Veteran | | Join Date: Sep 2009 Location: ZH
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| | Re: Preexisting conditions - dental insurance
Something else which is VERY IMPORTANT regarding dental insurance and Invisalign / Best Smile etc. , it is rarely covered by dental insurance. It is often considered esthetic treatment and not orthodontic correction.
I just heard this from my long time friend who is an orthodontist.
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19.08.2021, 09:32
| Junior Member | | Join Date: Apr 2021 Location: Basel
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | I would suggest you get an appointment with a qualified orthodontist to determine if your daughter is a possible candidate for orthodontic treatment BEFORE changing her insurance. I understand she is only 7, but her spacing, jaw structure, bite ( occlusion) and existent adult dentition is visible. ( need a panoramic x-ray) https://www.swissortho.ch/ | | | | | Don't do this. This seals it into her dental records that she needs orthodontic treatment. No insurer will ever accept her again. If today, she has no mention of needing braces in the future in her record, you might still be able to change coverage.
Agree with others who say don't drop the current coverage until you've been accepted without limitations elsewhere.
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19.08.2021, 16:59
| Member | | Join Date: Jul 2015 Location: Zurich
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | Once the new company accepts her, unless it's mentioned anything is excluded, she'll be covered per the coverage and waiting period. | | | | |
That's comforting. I see however that the general terms already include a clause about pre-existing conditions, so that would apply even if they are not aware of the preexisting condition, wouldn't it? I would still apply and see what they say.
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19.08.2021, 17:01
| Member | | Join Date: Jul 2015 Location: Zurich
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | Don't do this. This seals it into her dental records that she needs orthodontic treatment. No insurer will ever accept her again. If today, she has no mention of needing braces in the future in her record, you might still be able to change coverage.
Agree with others who say don't drop the current coverage until you've been accepted without limitations elsewhere. | | | | |
I was also thinking of avoiding a specific consultation for now, exactly for this reason.
Just to be clear, she has been to the dentist multiple times and nothing was mentioned, so I am not trying to hide anything. But a visit at a specialist would definitely raise flags.
Unless what they meant is to get the visit because if braces are needed in the future it's better not to change coverage now, because it would not be covered anyway after a switch.
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19.08.2021, 21:12
|  | Forum Legend | | Join Date: Nov 2007 Location: Switzerland
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | I was also thinking of avoiding a specific consultation for now, exactly for this reason.
Just to be clear, she has been to the dentist multiple times and nothing was mentioned, so I am not trying to hide anything. But a visit at a specialist would definitely raise flags.
Unless what they meant is to get the visit because if braces are needed in the future it's better not to change coverage now, because it would not be covered anyway after a switch. | | | | | The new health insurance will ask you to fill a questionnaire by a dentist anyway so better wait.
Why do you want to change dental insurance anyway?
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19.08.2021, 21:13
|  | Forum Legend | | Join Date: Nov 2007 Location: Switzerland
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | Don't do this. This seals it into her dental records that she needs orthodontic treatment. No insurer will ever accept her again. If today, she has no mention of needing braces in the future in her record, you might still be able to change coverage.
Agree with others who say don't drop the current coverage until you've been accepted without limitations elsewhere. | | | | | Which "record"? Insurers do not have access to your medical records. You need a dentist to fi a form when you apply to the insurance and of course you should not lie but there is no universal record to which insurers have access.
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24.08.2021, 18:24
| Forum Veteran | | Join Date: Feb 2008 Location: Zürich
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | Which "record"? Insurers do not have access to your medical records. You need a dentist to fi a form when you apply to the insurance and of course you should not lie but there is no universal record to which insurers have access. | | | | | It's not exactly a record per se, but the new insurer will ask as part of the application whether a dentist has ever indicated that orthodontics is needed. Therefore one should not get an opinion from a dentist prior to applying to dental insurance unless one plans to lie on the application about this.
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28.08.2021, 11:29
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| | Re: Preexisting conditions - dental insurance | Quote: | |  | | | Why do you want to change dental insurance anyway? | | | | |
We would like to get Semi-private insurance and ideally get a better price.
My employer has some new group offers so we may be able to save something.
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