Dental coverage limitations are restrictions on insurance benefits for top-up dental insurance
A significant proportion of people in Germany with public (statutory) health insurance opt to take out a private top-up insurance policy for dental treatment and services. Many consider the dental coverage in the public health insurance system to be insufficient.
However, the coverage provided by top-up insurance policies is usually subject to specific limitations. In the case of ottonova, these include a specific scale (Zahnstaffel) setting upper limits on maximum reimbursement for the initial years of an insurance policy, plus upper limits for specific services, such as professional tooth cleaning, fissure sealing and orthodontic treatment. The exact limits depend on the top-up insurance tariff you choose.
These limitations protect the insurance collective. Premiums in the private health insurance system are based on risk: if people were allowed to take out a top-up insurance policy and immediately claim extensive benefits with no upper limit, the cost of insurance would rise for everyone.