Having healthy teeth is important, but dental costs can be significant. And in most cases, those costs for adults are not covered by basic insurance. Only in specific situations, such as oral surgery or dental care for serious conditions, are the costs covered by the basic insurance. Children up to the age of 18 do get a large portion of dental care, such as check-ups and fillings, reimbursed from the basic insurance.
As an adult, you can purchase supplemental dental insurance to cover costs of oral care treatments such as teeth cleaning, cavity filling or crowns. Coverage and premiums vary by insurer, so it is important to compare them carefully.
What does dental care cost?
There are maximum rates for dental treatments established in the Netherlands, these are the same for every dentist, but depend on your specific situation. To give you an idea of what kind of costs we are talking about, here are some examples of average costs:
- Periodic checkup: €25 to €35 per visit.
- Dental cleaning (tartar removal): €60 to €100 per session.
- Small x-ray taking and review: €22.
- Filling: €50 to €120, depending on the material and size.
- Crown: €500 to €1,200, including placement.
- Root canal treatment: €250 to €900, depending on the number of root canals.
- Dental implant: €1,500 to €3,000 per implant, including crown.
What is covered by dental insurance?
Supplemental dental insurance can cover some or all of the cost of dental treatment. What should you look for when choosing supplemental dental insurance?
- The maximum reimbursement per year: many insurances have a maximum amount reimbursed annually, such as €250, €500 or €1,000.
- The reimbursement per treatment: most insurances reimburse checkups in full and the other treatments for 75% or 80% (all together up to the maximum amount per year). So you often have to pay part of the bill yourself, even if you have dental insurance. Other variations include reimbursing a fixed percentage of each claim, say 75%. A few insurers offer packages that reimburse claims for 100% up to the maximum amount per year.
- Exceptions often apply; not all treatments are covered. Cosmetic procedures, such as teeth whitening, for example, are often not covered. Also, orthodontics is by no means covered by every dental insurance policy (if you want to know more about that, read this article).
The deductible
Dental costs for adults are not covered by the deductible, which is only the case for care under the basic insurance. Children up to 18 have no deductible at all.
When is dental insurance useful?
If you have healthy teeth and need little dental care, it may be more economical not to take out insurance and pay for the treatments yourself. Dental insurance that covers up to €250 per year usually costs about €15 per month, which is €180 per year. If you expect to incur fewer expenses than €180, it is not interesting to take out dental insurance. You can also put that € 15 per month aside in a savings account in case you do incur dental expenses. When you have incurred few expenses at the end of the year, you can use the remaining money for something else.
If one of the situations below applies to you, dental insurance may soon be of interest:
- Regular dental cleanings.
- Complex treatments, such as crowns or root canal treatments.
- Need for dentures or implants.
If you log in to your health insurance company you can see how many dental expenses you have claimed over the past few years, this doesn't tell you everything, but it helps to make an estimate for the coming year. You can of course also ask your dentist if he foresees any costs in the coming year.
Medical selection or waiting period?
If you want to opt for a very comprehensive dental package, you usually can't just do so. Insurers want to avoid large financial risks, and the costs they have to reimburse in the most comprehensive packages can be high. By restricting access to these packages, they reduce these risks and thus prevent the premium for these packages from becoming very high. Insurers usually do this through medical selection or through a waiting period.
- Medical selection: You will receive a list of questions after applying from the insurer that you have to fill out yourself or that your dentist has to fill out. The questions are about the state of your teeth and whether high costs are already known to be coming. Based on this, the health insurer decides whether you qualify for dental insurance. Most insurers who use medical selection do so for packages with coverage of €1,000 or higher. If you are rejected for the comprehensive package, you usually automatically get a slightly more limited package, or you have the option to cancel the application.
- Waiting time: Some insurers apply a one-year waiting period for extensive, expensive treatments, such as crowns, bridges or implants. Waiting period means that you must have taken out the relevant dental package for one year before you can claim expenses for which the waiting period applies (e.g. crowns). In addition, you may only claim expenses in the year you incurred them. You can, however, claim other dental expenses such as check-ups and fillings in the first year with these packages.
Most health insurers apply an exception to the medical selection or waiting period when switching, if you can prove that you have comparable or higher coverage with your current insurer. You do not have to undergo a medical selection or waiting period again. This is also known as equal-over arrangement or equal-crossing.
Helpful tips
- Compare insurance policies: Coverage and premiums vary by insurer. Use the health care comparator to find the best option.
- Some insurers offer all-in-one packages: packages with additional coverage (such as physical therapy and glasses) as well as dental coverage. These packages are often slightly more affordable than separate supplemental insurance and separate dental insurance. So if you need both supplementary coverage and dental coverage, it may be interesting to take out this variant.
- Even people with healthy teeth may choose to purchase dental insurance. Another way to look at dental insurance is as a way to limit financial uncertainties. You can always have bad luck and unexpectedly need a filling or a crown. If you're worried about whether you can absorb those costs, dental insurance can give you more security. At least you won't have to pay (part of) the cost yourself.
- Have you come to the conclusion that dental insurance for your semi-annual dental visits is not of interest? Then there is one other coverage to consider: dental expenses after an accident. An accident is in one small corner, but it can lead to high dental costs. Many insurers offer a very limited supplementary package that pretty much only covers emergency care abroad and dental costs after an accident (usually up to €10,000). This package often costs less than €2 per month and thus provides coverage for this small but expensive risk.
Conclusion
Dental insurance can help you absorb unexpected high costs, but it is not always necessary. Consider your current dental needs and expectations for the coming year to determine if and which insurance is right for you. Compare different options to make an informed decision. We encourage you to consider this every year.
The benefits of group health insurance
- Take advantage of broader benefits than with individual insurance.
- Health insurance is there for you, your partner and children.
- We arrange your switch. Make a choice and we'll do the rest!