hTTi

Do GKK pay for Zahnreinigung?
I've always believed no, but maybe I'm wrong.

I have a (private, top-up) Zahnreinigung insurance and they apparently pay every Zahnreinigung. So today I filled my first claim (thanks ChatGPT for the letter). Got an automatic response instructing me too attach Rechnung and proof of payment (both attached already), as well as the rejection from the GKK. This Last was a big surprise.
For the record, my GKK is TK.

Thanks a lot

TK pays 40 EUR towards Prophylaxe only.

Kerfuffle wrote: ↑Sun Sep 14, 2025 7:34 pm TK pays 40 EUR towards Prophylaxe only.

Thanks.

Alberto wrote: ↑Sun Sep 14, 2025 7:46 pm

Kerfuffle wrote: ↑Sun Sep 14, 2025 7:34 pm TK pays 40 EUR towards Prophylaxe only.

Thanks.

I am a little annoyed by the way they replied because this way I am forced to write one more letter, to my GKK TK now, asking a refund, knowing already they won't cover it. And they may or may not reply. Yeah, whatever, there is worse in life...

Beside, this is what I don't get:
my dentist recommends TWO Zahnreinigung a year, so tot cost. ca 240eur/yr, or 20eur/month. This insurance I have apparently covers EVERY Zahnreiningung and it costs 16eur/months. Where is the catch?????????????

I suspect €120 per cleaning is what your dentist would charge you if you pay directly, but that the insurance pays somewhat less.
I also suspect that like all insurance policies they rely on the fact that many people will buy the insurance but never claim, and so averaged over all their customers it works out.
If they couldn't make a profit on the insurance, then they would have gone bust by now.

pappnase wrote: ↑Mon Sep 15, 2025 11:50 am I suspect €120 per cleaning is what your dentist would charge you if you pay directly, but that the insurance pays somewhat less.
I also suspect that like all insurance policies they rely on the fact that many people will buy the insurance but never claim, and so averaged over all their customers it works out.
If they couldn't make a profit on the insurance, then they would have gone bust by now.

Thanks