Is supplementary dental insurance worthwhile at all?

There is no blanket answer, because it depends on your dental health, age, family situation and financial risk appetite. It is mainly sensible for families with children, for people with an elevated treatment need and for young adults providing for the long term. Those who go regularly to check-ups and plan no major treatments statistically need it less often.

Can I still take out insurance shortly before a planned treatment?

No, that does not work. A risk check comes before conclusion, and already planned or foreseeable treatments are usually excluded. On top of that comes the waiting time, during which only emergencies are covered. An implant treatment planned in two weeks cannot be reimbursed this way.

How long are the waiting times for supplementary dental insurance?

It depends on the tariff. Basic tariffs often have around three months, middle and premium tariffs six to twelve months. With very high maximum amounts and elaborate treatments such as implants, the waiting time can be 24 months or more. During this time only emergencies are covered.

Are implants and whitening covered by supplementary insurance?

Often only to a limited extent. Implants are frequently at a reduced quota, with a long waiting time or not included in the tariff at all, so it is worth checking the implant clause before conclusion. Purely aesthetic treatments such as whitening are mostly excluded or only minimally reimbursed.

Is a savings account a sensible alternative to insurance?

For some people, yes. Instead of the monthly premium, you put the amount into a dedicated account. It has no waiting time and no reservations and can work out cheaper with good oral hygiene and rare treatments. However, it offers no protection against a sudden high need, for example when several implants unexpectedly become necessary.

Which supplementary dental insurance is worthwhile. Criteria for selection in Switzerland.

A question no one can answer flatly

Whether supplementary dental insurance is worthwhile depends on your current dental health, your age, your family constellation and your financial risk appetite. This article gives no blanket recommendation but explains the criteria by which you can decide for yourself.

The dental fundamental perspective is clear: supplementary dental insurance does not replace prevention. Those who go regularly to check-ups and dental hygiene statistically need significantly fewer expensive treatments. The supplementary insurance is a safeguard for the case that despite prevention treatments arise, or a help for persons with expectable higher treatment need.

How the Swiss system works

In Switzerland the mandatory health insurance under KVG covers dental treatments only in narrowly defined exceptional cases such as accidents or consequences of severe systemic diseases. Normally caries, root canal treatment, dental hygiene, implants and whitening are self-pay services.

A supplementary dental insurance covers part of these self-pay costs. It is concluded independently of basic insurance, often, however, with the same insurance because that simplifies administration. More on insurance logic in the article on health insurance at the dentist.

The most important criteria for selection

Risk check before conclusion

Every Swiss supplementary insurance carries out a risk check before conclusion. You either submit a dental status from your practice or answer a questionnaire about existing treatments, planned treatments, caries history and periodontitis.

The result can be:

Full admission without reservations
Admission with reservations, such as exclusion of certain treatments for a certain time
Refusal with strongly burdened dental status

Those who conclude an insurance at twenty usually have fewer reservations than someone at forty-five after years without insurance. That is the most important lesson: those who want insurance conclude it early.

Waiting times

Practically every supplementary insurance has a waiting time in which only emergencies are covered. Common waiting times:

3 months with basic tariffs
6 to 12 months with middle and premium tariffs
24 months with very high maximum amounts, sometimes longer for elaborate treatments such as implants

An already planned implant treatment cannot be covered through a short-term insurance conclusion. Those who get an implant placed in two weeks and conclude the insurance shortly before have no prospect of reimbursement.

Maximum amounts per year

Reimbursement is limited to an annual amount. Common maximum amounts:

Basic tariffs: CHF 500 to 1,500 per year
Middle tariffs: CHF 1,500 to 3,000 per year
Premium tariffs: CHF 3,000 to 5,000 per year, in rare cases above

With elaborate treatments such as multiple implants the maximum amount per year is the most important limitation. A treatment with total costs of CHF 10,000 can be submitted distributed over three or four years with a CHF 3,000 maximum amount, as long as the treatment sessions are correspondingly plannable.

Reimbursement quota

Common quotas:

50 percent with basic tariffs, sometimes with deductible
75 percent with middle and premium tariffs
90 or 100 percent with rare premium tariffs, often with conditions

The quota also varies by service type. Pure aesthetic treatments such as whitening are often not or only minimally covered. More on whitening treatment in the article on teeth whitening.

Acceptance of EMR and ASCA

For the reimbursement of dental hygiene most insurances require that the executing hygienist is registered in EMR or ASCA. More on this topic in the article on EMR and ASCA.

At Resident all hygienists are EMR-registered.

Premium amount

The monthly premium depends on age, region, chosen tariff and risk profile. Common bandwidth:

20-year-old person, basic tariff: CHF 8 to 15 per month
40-year-old person, middle tariff: CHF 25 to 50 per month
60-year-old person, middle tariff: CHF 60 to 120 per month

The premium rises with age because the expectable treatment need rises. Those who conclude at twenty often secure favorable premiums for decades.

When supplementary insurance is worthwhile

From a dental perspective sensible

Families with children and adolescents. Children’s dental treatments, orthodontic therapies and occasional caries treatments add up. A well-chosen family insurance often covers a significant part.

Persons with expectable caries susceptibility. Those with multiple root canal treatments or large restorations in the history have statistically an elevated risk for further treatments.

Persons with periodontitis history. Elevated risk for implant loss and for more elaborate recall programs.

Persons with planned dental replacement in the next ten to fifteen years. Those in middle life age who will foreseeably need implants, bridges or larger restorations benefit from early conclusion.

Young adults with good teeth who want to provide long-term. Low premiums now secure entitlement to later reimbursements when the need rises.

Less sensible

Persons without recognizable risk and solid oral hygiene. Those who go regularly to dental hygiene, brush well, have no caries susceptibility and plan no larger treatments are statistically rarely in the situation in which the insurance is worthwhile.

Very elderly persons without expectable treatment need. When the insurance is concluded first at sixty-five or seventy, premiums are high, reservations are frequent and the benefit is limited.

Persons who already have high treatment needs. Here the waiting times and reservations are the central problem.

Common pitfalls at conclusion

“I’ll quickly conclude now before treatment.” Does not work. Waiting times and the risk check prevent acute treatments from being covered.

“Highest maximum amount = best insurance.” Not necessarily. High maximum amount usually means high premium, long waiting time and strict risk check. For standard treatments a middle tariff is often sufficient.

“Whitening is also covered.” Often not or only minimally. Pure aesthetic treatments are mostly excluded or reduced reimbursed.

“Implants are fully insured.” Rarely. Implants are often at reduced quota, with long waiting time or not contained in the tariff at all. Those who plan implants check the implant clause in the tariff before conclusion.

“I can terminate at any time.” Swiss health insurance supplementary insurances usually have a three-month termination period at the end of a calendar year. Spontaneous termination is not possible.

How you compare tariffs

Comparison portals like Comparis and bonus.ch list the Swiss supplementary insurance tariffs. Pay attention when comparing to:

Maximum amount per year
Reimbursement quota
Waiting time for the specific treatment you plan
Reservations against already planned treatments
Implant clause (covered or not)
Orthodontics clause for children and adults
EMR/ASCA recognition for dental hygiene
Premium and premium development with age

A low premium with high quota on paper helps little if the waiting time excludes all your planned treatments.

What you should clarify before conclusion

Current dental status. A stocktaking at your practice before conclusion creates clarity about the risk profile. Resident documents on request a dental status for the insurance risk check.
Planned treatments in the next two years. These are usually not covered by the new insurance.
Family treatment need. Family insurances are often cheaper than individual insurances for each.
Own financial risk appetite. Can you cover an unexpected implant or a root canal treatment from liquidity? If yes, the insurance is less mandatory.

Supplementary dental insurance versus savings account

An alternative is self-saving: instead of monthly premium you put the amount on a dedicated account. With treatments you pay from the account.

Advantages: no reservations, no waiting time, full access. With good oral hygiene and rare treatments this can be economically better than the insurance.

Disadvantages: no protection against unexpected large treatment need. Those who suddenly need four implants at thirty usually have not built up the savings capital to fully cover that.

The insurance is a safeguard against the risk of high unexpected costs, the savings account is a plannable self-provision.

How Resident advises on this

We give no concrete tariff recommendation because the topic is individual. At initial consultation or recall session we document on request your dental status that you can use for the risk check.

We discuss your expected treatment needs (such as foreseeable root canal treatment or planned implant) and which treatments in which time window are realistic. With this information you can choose the right tariff yourself or with an independent insurance advisor.

Arrange an appointment at your location for a stocktaking. With financial constraints without insurance there is also the option of installment payment, more in the article on payment plans at the dentist.