Those who are smart keep a close eye on their health insurance. However, it is not always easy to determine whether it is wise to purchase supplemental insurance. In the long run, do the extra monthly premium costs outweigh the coverage you get? In this article, we discuss how supplemental insurance can cover the cost of glasses or braces and when this is of interest to you.
To decide whether you need a supplementary package, it is first necessary to know what is covered by the basic insurance. The basic insurance reimburses the most important care. The government determines annually which care is included, so this can change from year to year. The deductible must also be paid for most care from the basic insurance.
Care covered by basic insurance is, for example:
Sometimes you need more care, such as physical therapy, care around pregnancy, alternative medicine or the dentist. You can take out supplementary insurance for this. There are separate articles about these topics, which you can find here. But there are even more reimbursements in supplementary packages. In this article we discuss the reimbursements for glasses and orthodontics. These are not interesting for everyone to insure. We will gladly explain why.
Good vision is crucial to our quality of life. Unfortunately, glasses and contact lenses are only covered by basic health insurance when there is a medical indication; this is rare. If you need glasses or lenses, supplemental insurance that covers these costs may be a smart option. Reimbursement often includes prescription sunglasses or computer glasses.
Insurance policies offer annual, biennial or even triennial reimbursement for glasses or lenses. Reimbursements vary by insurer but often consist of a reimbursement with a maximum of €75 to €250. This is regularly insufficient, especially when you need progressive lenses.
It is usually not interesting to choose supplementary insurance just for glasses or contact lenses, because the premium will then be higher than the reimbursement. For a package that includes a reimbursement for glasses, you quickly pay € 20 per month, or € 240 per year. This is then more than the reimbursement you would get. If you are considering supplementary insurance because you also use other coverage, the glasses reimbursement can be advantageous.
Glasses and lenses are reimbursed from the supplementary insurance. These costs are therefore not covered by the deductible, which is only the case for care from the basic insurance.
Helpful tips
Many of us need braces at some point in our lives. This treatment can improve or prevent dental problems in children and adults. However, orthodontics is not covered by basic insurance (except in a few exceptional cases). Since the cost of braces and other orthodontic treatments can be significant, supplemental insurance that covers these costs may be a wise choice.
The amount of the reimbursement and the conditions vary by insurer. The reimbursement for orthodontics up to age 18 is usually between € 1,000 and € 3,000 and is often a one-time reimbursement. That is, this is not a budget per year, but for the entire period that you have taken out the supplementary package. The reimbursement for orthodontics from the age of 18 is much lower and is usually between € 500 and € 1,500. This is also often a one-time reimbursement.
Costs for braces
Most insurers operate with a waiting period for orthodontic reimbursement. This waiting period is one year. For children this waiting period applies to (almost) all insurers in the Netherlands, for adults there is sometimes no waiting period, but in those cases the reimbursement is also lower. Waiting period means that you have to be insured for orthodontics for one year before you can claim the costs. In addition, you may only claim expenses in the year you incurred them. This means that if you wait to get insurance until the braces program is about to start or has already started, you will not be reimbursed for the costs of the first year. Therefore, it is wise to plan your orthodontic course well.
In addition, it is important to check whether it is financially interesting to take out insurance for this. The premium for a supplementary (dental) insurance with coverage for orthodontics up to the age of 18 is often around € 35 per month, or € 420 per year. If you take into account paying an extra year's premium because of the waiting period, the premium cost for two years is € 840 (if the premium would not increase). If there is a compensation of € 2,000 in return, it can certainly be interesting to take out additional insurance. If the course is already ongoing, it can be less interesting, because generally the costs are highest at the beginning. Tip: Check the orthodontist's quote to see how much you will still have to pay and find out if this outweighs the premium you have to pay.
Because adult orthodontics reimbursement is much lower, it is less likely to be financially attractive. If you choose a supplemental or dental package just for orthodontics reimbursement, the reimbursement you receive is often less than the premium you have to pay. If you are considering supplemental or dental insurance because you also use other coverages, adult orthodontics reimbursement can be beneficial, however.
An example: You have had dental insurance for several years because you regularly have high dental expenses. That same dental package also includes coverage of €1,500 for orthodontics for children. Your son or daughter is now due for braces and the waiting period for the current coverage has already been met. The orthodontics costs could be claimed directly. But the orthodontist's quote falls high. So you would actually need higher coverage. Your insurer also offers a package with coverage of €2,500.
The question then is: if you change your package with the same insurer for higher coverage, does a waiting period apply again?
The answer to this question varies by insurer. Sometimes the insurer is strict and you have to meet the entire waiting period again for the new package. With other insurers, you only have a waiting period for the additional budget that is added. If we go back to the example where €1,500 was covered and that would be changed to €2,500, the waiting period only applies to the extra €1,000.
Whether supplemental health insurance is of interest to you depends entirely on your personal circumstances and needs. Because your circumstances may change, we recommend that you review this every year. It is important to carefully weigh the monthly premium against the possible costs you would have to pay without the insurance.
In any case, what is clear is that supplemental insurance can be a valuable tool to reduce financial uncertainties. In short, choosing supplemental health insurance is not only a healthy choice for your body, but also for your wallet!