As a member of a statutory health insurance fund, the bonus booklet has been proof of regular visits to the dentist for you and your co-insured family members since 1989. If you do not yet have a bonus booklet, you should definitely talk to your dentist about it the next time you visit the practice. Fully managed, it helps you to save money if, despite regular preventive care, dentures are needed. Your health insurance company rewards you for the regular check-ups with an increased subsidy towards the cost of dentures.
Patients older than 18 years should make an appointment with a dentist for an examination at least once a year, children from the age of 6 and adolescents up to the age of 18 twice a year. For children and adolescents there is a special prevention program, abbreviated IP program (IP=individual prophylaxis). In the bonus booklet, the day of the examination or the prophylaxis measure is recorded and confirmed with a stamp of the dentist. In order to receive a higher subsidy for dentures from the health insurance fund, the bonus booklet must be kept without gaps.
If, at the time of applying for the fixed subsidy for dental prostheses, you can prove regular examinations at the dentist over a period of at least five consecutive calendar years, the fixed subsidy increases by 20 percent. If you can prove the corresponding appointments for ten years without gaps, the subsidy from the health insurance company increases by a total of 30 percent. Important: For the calculation of the higher subsidy, the past calendar years count. The stamp for the current year does not count, if it is already available in the bonus booklet.
If proof of the regular examination is missing in the bonus booklet (adults one stamp per year, children and adolescents one stamp per six months), you should ask your dentist to add it as soon as possible. The prerequisite for this is that the examination or, in the case of children and adolescents, the prophylaxis measure was also carried out during the period in question. This is documented in the patient file.
Missing periods can also be confirmed and stamped retrospectively, but only by the dental practice where the check-up appointments were carried out. However, the longer these are in the past, the more complex a subsequent documentation becomes both for you and for the dentist and his staff. If it is associated with a considerable expenditure of time for the practice team, an expense fee may be incurred. In special cases, such as the closure of the practice or the transfer to a new owner, it may happen that subsequent documentation is no longer possible, as it could only be reconstructed with the patient file.
Therefore, please note: It is your responsibility to remember the entry in the bonus booklet.
If entries are missing because the investigation did not take place during the relevant period, the bonus regulation no longer applies. An entitlement to a bonus only exists again if the control dates of the past five years can be proven.
If you lose the bonus booklet, your dentist will help you. Based on the entries in the patient file, he can understand when you were with him for examination or prophylaxis treatment. Issuing a new issue is time-consuming and should remain the exception. If you have been treated by different dentists, you need the corresponding entry from each practice, as only the dental practice can confirm the check-up on the basis of the patient file. The KZBV or the Association of Statutory Health Insurance Dentists in their federal state cannot help in such cases.
It is therefore best to keep the bonus booklet just as carefully as your identity card. Important: When changing dentists, the bonus booklet does not lose its validity. The new dentist will continue the necessary entries or may issue a new booklet. The "old" or "full" booklet should be kept in any case. In the case of an upcoming treatment with dentures, it must be submitted to the health insurance company together with the new booklet.
The bonus booklet is worth cash later – namely when dentures are necessary. But your own oral health and the lifelong health of your own teeth should be in the foreground of regular visits to the dentist. Because no dentures can be as good as the original it replaces – and no bonus brings in so much money that dentures could be paid for in full.
The statutory health insurance cannot cover all the services that modern dentistry offers you. But you have the opportunity to enjoy more freedom in the choice of therapy: With the reimbursement of costs, you can use the latest diagnostic and treatment options without losing the subsidy from the health insurance company to which you are entitled for the statutory benefit. This can be useful, for example, in periodontitis therapy, root canal treatment or orthodontic treatment of your children.
If you choose reimbursement, you no longer need to present your health insurance card or health card in practice. You will receive an invoice according to the private fee schedule for dentists (GOZ). You submit the invoice to your cash register, from which you will receive a refund.
Some health insurance companies also make a cost contribution for certain therapies, such as the supply of dental prostheses, dependent on an approval procedure before the start of treatment. The following applies to all health insurance companies: If the treatment chosen goes beyond the benefits of the health insurance company, additional costs will be incurred, which you will have to bear yourself, unless you have supplementary insurance that participates in it. The fund reimburses only the costs that would have been incurred if the insurance card had been billed. In addition, it can deduct administrative costs of a maximum of five percent from the reimbursement amount. You can choose reimbursement for yourself and/or co-insured family members and limit it to dental care. The decision shall be valid for at least three months. The dental profession is committed to making the procedure even more patient-friendly in the future.
Before you make use of services, inform the health insurance company of your decision to reimburse the costs. Your dentist will tell you the details. Some health insurance companies also offer special reimbursement rates for which you must conclude a contract.
Responsible body within the meaning of the data protection laws, in particular the EU General Data Protection Regulation (GDPR), is:
Dr. N.-T. Vo
Strawberry Trail 52
26605 Aurich, Germany
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The treatment and cost plan (ICP) is the basis of every dental prosthesis. If you need crowns, bridges or dentures, your dentist will draw up a treatment and cost plan. On this plan you will find information about the dental status in your mouth (findings), the standard care as well as the planned therapy and the expected total costs. The treatment and cost plan is intended to give all parties involved security of action. It will be handed over to your health insurance fund for examination, approval and subsidy determination before the start of treatment. The difference between the total cost and the fixed subsidy is your own contribution. As soon as the plan approved by the health insurance company is available, treatment can begin.
The treatment and cost plan
The treatment and cost plan is divided into different sections:
In the declaration of the insured, confirm in each case of treatment by your signature