The Appointment Service and Care Act (TSVG), which came into force in May 2019, makes it possible: From October 2020, those insured under statutory health insurance will be entitled to a higher fixed subsidy at the dentist.
For many people, visiting the dentist is a very painful topic. Pain in the teeth or inflammation of the gums often make the visit unpleasant. But that's not all, the costs of dentures also leave a bitter aftertaste. From October 1, 2020, those with statutory health insurance will at least be given some financial relief. The fixed subsidy for dentures will increase.
The Appointment Service and Care Act, TSVG for short, regulates, among other things, the fixed subsidy in the area of statutory health insurance for dental prostheses. As of October 1, 2020, the subsidy will increase by 10 percent. This increases the subsidy for dental prostheses from 50 percent to 60 percent. Along with the increase, the bonus for regular check-ups at the dentist.
Subsidy for dental prostheses newly regulated from October 1, 2020
Currently, insured persons receive a reimbursement of 50% of the costs for standard care from the statutory health insurance, without bonus payments. This corresponds to half the cost of dental prostheses such as crowns or bridges. The other half is to be borne privately by the insured person. However, the 50 percent rule only applies to the Standard care. In other words, the ffor the standard therapy assigned to the finding.
If the patient opts for a better and higher quality type of treatment, i.e. against a metal crown, then the additional costs incurred are must be paid privately by the insured person. The health insurance companies only cover the hhalf the costs of standard careSince the costs of higher quality care are significantly higher than those of standard care, the health insurance contribution through this shrink to 40 or even just 30 percent.
Fixed subsidy as a reward for regular preventive care
In order to reward regular dental care, the fixed allowance will increase from 1 October 2020 – taking into account the bonus booklet – from 60 percent to 70 percent. This requires the submission a seamless Bonus booklet. This must document regular dental check-ups over a period of at least 5 years. If you can prove more than 10 years, the fixed subsidy increases from the current 65 percent to 75 percent.
The decisive factor for the granting of subsidies under the new regulation is the date of issue of the treatment and cost plan.
Failure to attend preventive care appointments may be taken into account in exceptional cases from October 2020
Currently, if a preventive care appointment is missed and the corresponding stamp is missing in the bonus booklet, the entire bonus expires. The patient must "save up" his bonus again. From October 1, 2020 The failure to attend the annual dental check-up has been newly regulated. In justified exceptional cases, the bonus, despite the missing stamp, remain preserved.
Example calculation for tooth gap in molar area:
Fixed subsidy of 50% of the standard care. In this case, the standard care corresponds to a veneer with a base metal. The so-called NEM bridge (non-precious metal bridge).
Current subsidy: 374.38 euros (50% of 748.76 euros)
Subsidy from October 2020: 449.26 euros at 60% without bonus portion until to 561.57 euros at 75% with bonus portion
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