The term Tooth Stagger applies to everyone who deals with private health insurance or with additional dental insurance. The rack of teeth plays a crucial role in connection with dentures. Special attention should be paid to it when choosing the appropriate tariff.
- The tooth stagger limits the benefits for dentures in the first few years.
- In spite of the lower premium, low tooth scales are only recommended to a limited extent.
- It makes more sense to offset it against the calendar year than against the insurance year.
- The first insurers are now foregoing the waiting time that used to be common.
What is the tooth stagger?
Insurers like to limit their risks. A policyholder takes out additional dental insurance for 30 euros a month. After three months, the dentist determines that extensive dental prosthesis measures are necessary. The cost estimate is 4,000 euros. The contract term of the insurance is two years. Assume that the policyholder has his teeth restored and terminates the contract after two years. For the insurer, this means a loss of 3,280 euros.
With this in mind, the tooth stagger was introduced. It shows how much the insurance will pay in the first few years. A tooth stagger could look like this:
|In the first year||Up to 1,000 euros|
|For the first two years in total||Up to 2,000 euros|
|For the first three years in total||Up to 3,000 euros|
|For the first four years in total||Up to 4,000 euros|
|From the fifth year||Unlimited up to the agreed service|
It is also important whether the limitation is based on the calendar year or the insurance year . Example: The insurance year started on June 1st. In December, a denture benefit of 1,800 euros will be necessary. The treatment consists of two appointments. If the insurance year applies, the second treatment can only be carried out in June of the following year. If the calendar year is the assessment period, the treatment can be continued seamlessly in January.
The height of the tooth stagger naturally also has an effect on the premium. Such a rack would be significantly cheaper:
|In the first year||Up to 500 euros|
|For the first two years in total||Up to 750 euros|
|For the first three years in total||Up to 1,000 euros|
|For the first four years in total||Up to 1,250 euros|
|In the first five years||Up to 1,500 euros|
It remains questionable whether this staggering is expedient against the background of the cost of dentures. Dentures are expensive. In the first five years, however, you could only expect a replacement of 1500 euros – in total!
What is the significance of the tooth stagger?
The importance of the tooth stagger lies in the cost limitation of the insurer. However, in consultation with the dentist, the policyholder can control the costs of possible dental prosthesis expenses. If the dentist is consistently based on the tooth scale, he avoids additional costs for his patient.
What happens to the tooth stagger when changing tariffs?
If a policyholder changes to a different tariff as part of a private full health insurance, the tooth scale itself remains unaffected. The insurance companies usually use one specification for all tariffs.
The tariff change can, however, have an impact on the reimbursement amount for dental prosthesis services. Usually the insurance companies offer different reimbursement rates. Depending on the insurer, the bandwidth ranges from 50 percent to now even 100 percent.
The situation is different from changing tariffs when changing health insurers. In this situation, the possible entitlements are no longer valid after, for example, two claims-free years. The tooth stagger applies again from the beginning.
Is there an additional dental insurance without a dental stagger?
There is currently no insurer on the market that does without a sum limit, i.e. a toothed scale. Some companies advertise that they offer dentures with no benefit limitations. However, these are the exception. What is also new is that some insurers do not have to wait for dentures. Up to now, lead times of up to eight months have been the rule. This should prevent the insured person from using expensive dental prosthesis services after the first premium payment. The classic dental treatment for pain is of course excluded.