The ceramic crown and the single room in the hospital have one thing in common: You have to pay for these services yourself. In principle, health insurance is not involved. Many patients therefore take out health and dental insurance to reduce their financial risk. This extra protection is very popular. In 2020, 16.9 million Germans already had supplementary dental insurance. The market has been booming for several years and there is no sign of a decline in demand — also due to the corona crisis. But what do these supplementary insurance policies really offer and which benefits are covered by the policies?
This is what health and dental insurance does
Required medical or dental services, which are “sufficient, appropriate and economical” in accordance with the Social Code, are covered by statutory health insurance funds. If standard care is not enough for you or your health insurance patients, further benefits must be (co-) financed out of your own pocket — unless they have supplementary private insurance. These policies enable you to close cost gaps that exist between health insurance reimbursement and the invoice amount.
What benefits does supplementary insurance cover?
Supplementary insurance is used by patients to absorb the costs arising from extra services. It involves:
- Services that are generally not covered by health insurance companies
- Services that are not fully covered by the health insurance fund but are subsidized
- Services that are only covered in exceptions that require justification
Private supplementary insurance offers various policies that include one or more benefit categories. Since the market is confusing, it is difficult for many to find the insurance they want right away.
These health and dental insurance policies are available
There is a wide range of supplementary insurance. However, there are particularly popular policies, which include these:
- Supplementary hospital insurance
- Daily sickness benefit insurance
- Supplementary dental insurance
- Supplementary care insurance
- Supplementary outpatient insurance
- International travel health insurance
However, before you take out one of these insurance policies, you should know what you need to consider.
This is how private supplementary insurance works
You finance the extra protection for your health on a monthly or annual basis Contribution fees. The amount depends on your age and your general health status upon conclusion of the policy.
In principle, older people and previous patients pay higher rates! Based on these criteria, insurers can also reject you as a customer Risk surcharges require or completely exclude certain services. There is no compulsory admission — unlike statutory health insurance companies.
In addition, the offer offered by private insurers is not based on a legally regulated Scope of services. Insurers may determine their range of services themselves. For patients, therefore, only the agreed services in the contract terms apply.
Special features of supplementary dental insurance
The current bill for your dental treatment will be higher and you would therefore like to take out additional insurance after all? Unfortunately, this will not help you to absorb the costs in this case. Ongoing treatments are generally not covered. Therefore, be sure to take out the additional policy before starting treatment!
Attention: According to many insurers, as soon as you, as a doctor, recommend treatment to your patient, the treatment process begins.
Beware of the waiting period
There is often a waiting period of several months before your insurance coverage takes effect. Patients may have to wait up to eight months, particularly with additional dental policies. However, concealing treatment when taking out the policy is not an effective strategy. Many insurers will check your details as soon as you apply for reimbursement. What many people don't know is that the benefits of supplementary insurance are also limited. Therefore, make sure to what extent the insurance covers the costs.
What does “full protection” mean?
Despite the promised “all-round” or “complete protection,” many providers limit their coverage of costs, especially for dental treatment, to fixed maximum amounts per year. Before patients agree to privately financed treatment, they should consult their insurer.
Is the extra protection worth it for you?
Health is the most valuable asset — for which many people are happy to pay extra. However, not every patient needs additional insurance. Statutory health insurance companies already offer comprehensive protection. So how do you determine whether supplementary insurance makes sense for you?
How to find out whether you are eligible for supplementary insurance
Extra protection is not only a question of individual sense of security, but also a question of cost for many. First, consider: Would you be able to bear the financial risk without insurance? If it would be difficult or even life-threatening for you to cover your private costs, extra protection may be advisable.
However, financial options not only play a role in terms of the risk of a lack of insurance coverage: Additional policies also cost money. Although many are already available for small amounts, others are proving to be more expensive. Anyone who takes out several insurance policies may pay more in total than their financial leeway allows.
Tip: Before you take out a policy, compare the offer with other providers. This is how you find out whether your preferred tariff really guarantees the protection you want. Comparative tests can be found, for example, at Stiftung Warentest.
How great is your health risk?
You should also ask yourself which benefits insurance really pays off for. Anyone who never goes on vacation abroad does not need an appropriate policy. Because you still pay for them, even if you don't use them. “A lot helps a lot” may provide psychological security, but it is not necessarily profitable.
Many doctors are also concerned with these considerations. After all, they know the benefits of private insurance from everyday working life.
Extra protection for doctors: Does it make sense for you?
As for your patients, health insurance is essential for you as a doctor. However, not everyone wants or is allowed to take out private insurance. Private supplementary insurance can therefore usefully expand your insurance coverage. After all, you are aware of the differences in benefits between private and statutory insurance.
However, the same applies to doctors: Carefully weigh the costs and benefits of the policies and compare providers. There are often special, sometimes cheaper medical rates for doctors. Advice from an independent insurance broker specifically tailored to academic health professions may help you find the right supplementary health insurance.
Attention: Insurance policies are also often complicated in the medical sector and insurance agents often do not provide independent advice.
Nelly makes it easier to process additional services
As a doctor, you know additional services not only as tariff descriptions, but also from medical practice — with everything that goes with them. Because if patients want to take advantage of additional services in your practice, you need them signatures and consents. And after treatment, accounting processes follow. To make these steps easier, you can use Nelly! Thanks to Nelly, you can offer your patients modern payment options such as direct debit or credit cards. You also save your practice team a lot of time when it comes to billing — an average of 90 minutes per day.
Now you too can create a digital workflow in your practice. We advise you non-binding and free to your individual case!
The personal names used in this article always refer equally to all persons. Dual naming and alternate names are omitted in order to improve readability.
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