Aok dental cleaning

14 posts in this topic

Hello!

I have AOK insurance through work. I recently went through a normal yearly cleaning at the dentist. AOK refuses to cover any of it. They sent me a letter that they will only pay for it if I have been in their program of dental cleaning before the age of 25. 

I havent even lived in Germany until the age of 26. 

Its 95€ that I would like to avoid, any advice or similar experiences? This seems incorrect to me. I thought I had partial coverage of one cleaning per year?

Thank you

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Health insurers are not obliged to cover for tooth cleaning.  Some do, some do not or at least restrict it.  It is probably worth asking about the bonus program which gives you extras if you go to the dentist regularly and look after your teeth.

 

AOK Rheinland/Hamburg

 Professional tooth cleaning for all insured?: No, but full coverage for a certain group of people (insured between 16 and 25 years. If the benefit was used at least once at this age, the entitlement is permanent. Even after the age of 25. ), in the entire supply area, max. Once per calendar year, but subsidy for a certain group of people in the amount of max. 35.00 EUR (insured between 16 and 25 years. If the benefit was used at least once at this age, the entitlement is permanent. Even after the age of 25), in the entire coverage area, max. Once per calendar year, at all dentists; Subsidies possible as part of a bonus program.

 

https://krankenkassen.focus.de/kasse/1/AOK+RheinlandHamburg

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I received a payout of €60 specifically for dental cleaning for 2019, but the cleaning appointments last year I had cost more than that overall. In fact just one appointment was more than that, so the cover is only partial and if cover for this sort of thing is not compulsory in Germany (I have no idea, plus I don't know anywhere that it is), it could indeed vary somewhat depending on your insurer. 

 

Unless you've taken out a specific policy, I would not expect any cover, let alone full cover. Generally speaking you're on your own when paying for any dental work. I had no idea that anything like this was paid for here and found out by chance, but worth following through to get the money. :)

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I'm with TK and they have a bonus programme that  gives you some discounts (eg on false teeth) but only if you go regularly for checkups. I think a simple scale and polish is free as is the checkup, but the more thorough professional clean not automatically. However, to my surprise I did get the full deep clean free a couple of years ago as I go regularly and had apparently built up the required number of visits . My dental practice seems to monitor stuff like this very well, and always lets me know how to lower the bills when poss. The cost of a full profi clean is around €70 with them, for the best part of an hour's work. 

I've been very happy with TK over the years and the health care in general here in Germany.

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TK, and  I bet AOK, does cover a yearly preventative check up, where they check your gums and look for cavaites and stuff.  

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With AOK- they cover basic cleaning, and  a charge for more extensive cleaning. Worth the cost  6 monthly cleaning keeps the pearlies white!!

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7 minutes ago, RedMidge said:

With AOK- they cover basic cleaning, and  a charge for more extensive cleaning. Worth the cost  6 monthly cleaning keeps the pearlies white!!

 

Not all AOK.   Different AOKs offer different things.   The OP seems to be in Hamburg, so I posted the details for AOK Rheinland/Hamburg and the very limited conditions under which they cover some cleaning.  I would guess you are with AOK Nordwest, who are more generous and cover basic cleaning twice a year.

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go on check24 and compare health insurances - then change!

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On 07/07/2020, 08:34:26, dom said:

go on check24 and compare health insurances - then change!

 

though could be swings roundabouts thing especially with the bonus program if you go regularly to dentist.  I speak as someone who has always gone to the dentist but now have become phobic.  Which is really stupid.  Have not been for years and that makes me even more reluctant to go.  Am obviously going mad.

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12 hours ago, snowingagain said:

I speak as someone who has always gone to the dentist but now have become phobic.

 

Assuming your local dentist is "normal", you should resume your regular visits!

I have been MORE OFTEN since corona, because the practice has less patients (because of people like you)!!

You do realise, that the worse your dental health, the MORE LIKELY you are to catch bacterial and viral infections!!

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Thank you everyone! I appreciate all your information! From the information I've acquired they wont cover it unless I have been through there coverage before the age of 25 (impossible for me). This came into effect in 2017

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maybe you can prove that you went to the dentist regularly abroad?

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20 hours ago, dom said:

 

Assuming your local dentist is "normal", you should resume your regular visits!

I have been MORE OFTEN since corona, because the practice has less patients (because of people like you)!!

You do realise, that the worse your dental health, the MORE LIKELY you are to catch bacterial and viral infections!!

 

You misunderstand.  My reluctance to go to dentist is not  related to fear of catching Covid 19.  Last visit was years ago.  Which I realise is stupid, but stupid for a different reason!  

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oh sorry, I read your message too quickly. Yes, phobia sucks! 

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