Switzerland may be the land of delicious chocolates, herbal candy and quality ice cream, but it is also the land of eye-watering dental costs. While all residents are legally obligated to take out health insurance, the basic health insurance provides almost no coverage for dental care.
Ironically, dental problems are probably the most prevalent malady in the modern world. Nearly everyone requires dental care at some point in their lives, and even mild dental problems can cause so much pain that they can render a victim unable to work or go about their business. While there is only a small chance of your getting cancer or another expensive-to-treat illness, dental problems are virtually a given.
The Swiss Dental Association (SSO) tariff recommendations place the maximum cost of a 3-ply gold filling at 1229.60 francs (212 times the base rate of CHF 5.80), while the cost of a hybrid prosthesis can reach 2082 francs (359 times the base rate of CHF 5.80). Some dentists in Switzerland charge prices higher than those recommended by the SSO.
Complex dental operations can drain your piggybank to the tune of thousands of francs, while orthodontist bills can climb into the 5-digit range. So what dental insurance is available in Switzerland and how can you protect yourself from the financial consequences of a toothache?
Basic health insurance
If you live in Switzerland, you probably already have compulsory health insurance. So it is worth knowing that your basic policy does provide coverage for a handful of dental scenarios.
Your mandatory health insurance policy covers dental emergencies which can potentially impact your health, such as serious infections and damage to your teeth and jaw resulting from cancer and other serious illnesses (or by medical treatments). Damages caused by accidents are also covered, but only if you do not already have coverage from accident insurance, dental insurance, supplementary health insurance, travel insurance or other insurance policies.
In other words, your basic health insurance protects your teeth in the case of total – and fortunately very unlikely – dental disasters. You can find out what other coverage you get from your compulsory health insurance in this moneyland.ch guide to basic health insurance benefits.
Supplementary health insurance
If you have optional outpatient insurance, there is a chance that your policy provides coverage for dental care. However, most policies that include dental benefits only provide this coverage until you reach a certain age (18 or 25 years old, for example) and in almost every case, coverage is limited to a certain percentage of costs (25% or 50% for example). Additionally, the benefit is usually capped at a low maximum sum insured (CHF 1000 per year is common).
The CSS myFlex Balance covers 50% of dental treatment costs, up to a maximum of CHF 1000 per year, but only for policyholders up to 18 years old.
Sanagate’s Optima provides the same amount of coverage, and also limits coverage to those no older than 18.
Some insurers use the SSO rates as guidelines for the benefits they pay out, so the benefits you get may not reflect your full expenses if you use a dentist which charges prices above the SSO guide rates. It is also important to note that, depending on your policy, a deductible may apply to dental benefits as well.
Assura’s Complementa Extra policy covers up to CHF 1500 of dental costs every year, but only after you make up the policy’s CHF 500 annual deductible. Assura also uses SSO guide rates as the basis for benefits. The upside of this policy is that it does not place an age limit on coverage and it covers treatment at certain eligible dentists outside of Switzerland in addition to treatment by local dentists.
The Visana Ambulant II and Ambulant III are two more policies which do not place age limits on dental benefits (25% max. CHF 500 per year and 50% max. CHF 1000 per year respectively). However, benefits only apply to specific dental procedures, including the surgical removal of wisdom teeth and the removal of damaged teeth.
Sanitas Family covers 80% of the cost of wisdom teeth removal, up to the limits of your selected annual sum insured.
But while the dental coverage you get with most supplementary health insurance policies is weak or even non-existent, the orthodontics coverage is often very attractive.
The most generous policies cover as much as 80% of the cost of braces, retainers and other tooth or jaw realignment therapy. As a rule, orthodontic treatments are limited to children and adolescents (though some policies push the limit as far as 30 years old).
Visana Ambulant II and Ambulant III policies cover 80% of orthodontic costs up to a maximum of 10,000 francs per year, but only after you have held your policy for at least 18 months.
Sanitas Family covers 80% of the cost of orthodontic therapy for those under the age of 19, up to the limits of your preselected sum insured.
Insurance providers generally require you to present quotes from orthodontists for approval before you proceed with treatment. This is especially true for expensive treatments. You can find more information in the moneyland.ch guide to orthodontic insurance for young people.
Important: Qualification periods apply to most dental benefits. You may have to hold a specific policy for 6 or 12 months before you can take advantage of dental coverage. Qualification periods as long as 18 or even 24 months may apply to orthodontic treatments or major dental work. Do not wait until you actually need treatment to get insurance, and make sure to account for qualification periods when calculating the financial benefits of dental coverage.
Dental insurance is primarily offered by the same insurance companies which provide health insurance. Some insurers provide dental insurance as a stand-alone policy, while other insurers let you add dental insurance coverage as a rider on your outpatient insurance policy – for an added premium.
Many Swiss dental insurance providers require you to prove that your teeth are generally healthy by taking a dental exam before they provide you with their more comprehensive policies. Lower-coverage policies, on the other hand, can normally be applied for without a medical report, and the examination requirement may be waived for very young children across high end policies as well.
Swiss health insurance provider Helsana provides several versions of its Dentaplus dental insurance, with its “Light option” covering 75% of dental costs but only up to a maximum benefit of CHF 300 per year and its highest-end “Gold option” covering 75% of costs up to a maximum sum insured of CHF 3000 every year.
Dental insurance policies from CSS start at 50% coverage capped at 1000 francs per year, which is almost identical to the dental coverage you get with its Balance and Premium outpatient insurance policies, but without the 18-year-old age limit. Higher coverage from CSS is provided by its 75% coverage policies, which extend coverage caps to CHF 2000, 3000 or 5000 per calendar year (a medical exam is required for the CHF 3000 and CHF 5000 options).
The Dentaire Plus policy from Groupe Mutuel (available to those 60 years old or younger) covers 75% of dental, orthopedic and laboratory costs up to caps of 1000, 3000 or 15,000 francs per year, depending on the policy you choose.
In some cases, getting dental insurance from your health insurance provider can make sense because some insurers offer multiple policy discounts. For example, CSS offers a discount when you combine a dental insurance policy with your supplementary health insurance policy.
Important: Like the dental coverage you get with supplemental health insurance policies, Swiss dental insurance policies generally come with qualification periods. Typically, you will have to hold your policy for at least 1 year before you become fully covered and can take advantage of the dental benefits.
Is dental insurance worth it?
Premiums for dental insurance range between CHF 10 and CHF 100 per month, depending on your age, the coverage provided and the deductible you choose, and in some cases even your place of residence. If your dental care expenses are relatively low (1500 francs or less), getting a bundled supplementary health insurance policy that includes dental insurance makes more financial sense than getting a specialized dental insurance policy, because for a relatively small additional premium you get many extended health insurance benefits which could benefit you even if you do not end up needing dental work.
But if your main concern is protecting yourself from high-cost dental treatments, getting a dental insurance policy with a very high maximum sum insured (like CHF 15,000 per year) can give you that protection. Depending on your dental expenses, a high-benefit dental insurance policy can be worth it. For example, if you were to pay 90 francs per month for a 75% (max. CHF 15,000) policy over a 5-year period, your premiums would total CHF 5400 over that period. If your dental costs during that time totaled CHF 20,000 francs (but never more than CHF 15,000 in any one year), you would receive benefits totaling 15,000 francs. Subtracting the CHF 5400 francs you paid in premiums, your “savings” would come to CHF 9600, so dental insurance would certainly pay off in this case.
On the other hand, if your dental costs only amount to a few hundred francs per year, getting dental insurance will not normally be worth it.
Do you need dental insurance?
A good first step is to visit a dentist for a thorough dental checkup to establish whether or not major dental or orthodontic problems are likely. Getting a thorough dental report ahead of signing up for a policy will also arm you with evidence which could come in handy if your insurance provider decides to withhold payment on account of alleged pre-existing conditions.
When assessing whether or not you are likely to suffer from dental problems, it is important that you consider your parents’ dental history, your lifestyle habits and your overall health. While nearly everyone needs dental care at some point in their life, the amount which you spend (or expect to spend) on dental care will determine whether you will save more by banking your dental savings, getting affordable dental insurance with low benefits for regular, ongoing use, or investing in high premiums for a high-coverage policy.
Last update: November 2017