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Dental insurance plan

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.

If you need costly treatments, which are likely to cost more than €1,000, we recommend that you ask your dentist for a treatment and cost plan. In this plan, the dentist will specify which treatments are planned, and at what cost.

This treatment and cost plan has two parts: one for public health insurance, and one for private health insurance. First, you should submit the relevant part to your public health insurance. Your public health insurance will assess it and will usually approve it. You should then take a picture of that approval and of both parts of the health and cost plan using your smartphone, and upload it to your app.

It is important that ottonova receive the treatment and cost plan in well before the start of the treatment. ottonova will then notify you of the expected reimbursement. Once your treatment has been carried out, you can send us your bills and we will reimburse you. Public health insurance usually bears the costs for the treatment and cost plan. If it does not do that, or if it does so only in part, we will reimburse the rest.

You are eligible for our dental plans if you are currently insured by German public health insurance (GKV). ottonova is right for you also if you care about your dental health and about prevention. Our aim is to actively support you in keeping your teeth healthy by reimbursing teeth cleaning, other prophylactic treatments, diagnostic tests to predict your risk of cavities, and fissure sealants.

In the first 48 months, you can only use your benefits up to a certain limit. Therefore, we want to prevent your premiums from being used to co-finance the treatment for customers who were already ill before they signed up for our insurance. However, should you have an accident, you will be able to claim the full benefits of your plan before the end of the waiting period.

The older you are the more expensive dental work you usually need. This, of course, raises the cost.

That is why the premiums of your top-up dental insurance increase incrementally between the ages of 18 to 60. This usually happens every five years and is planned in advance.

Your premium depends (in simple terms) on the average costs that your respective age group is likely to incur.

You can find the premium table here (in German).

How much we reimburse depends on your plan. All three plans cover 100% of dental treatments. Our Economy Class plan covers at least 70% of the costs of dental prostheses, together with your public health insurance fund. In Business Class, the reimbursement for dental prostheses increases to 85%. In First Class, we cover 100% of the costs.