Health (& Dental) Insurance for Kids?

Quick question - if you make dental insurance for newborn (eg. 10chf per month), does it stay same price for rest of the life? Somehow I doubt and I see usually they put term to 5 years, after which I bet they will up it. Comparing insurance for 1y and 5y year old is 10 vs 30chf.

No, it does not

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I have done some comparison recently in my canton focusing on orthodontic treatment until age 20 y.o.
Orthodontic experience from friends: work starts at age 13-14 y.o., second child age 8-9 y.o. I went to the first one for all the family.

Helsana TOP
Orthodontic treatment/wisdom teeth:
Up to the age of 20, you receive 75% of the costs, up to a maximum of CHF 10,000 per calendar year, for the correction of dental or jaw misalignment (e.g. braces) and the extraction of wisdom teeth.

Details of coverage
Benefits for those with supplementary insurance

Eyeglass lenses
You receive 90% of the costs, up to a maximum of CHF 150 per calendar year, for your eyeglass lenses and contact lenses.

Total per kid = chf12,80/month, 154/year, 2458/16 years (from age 4)

As an adult of 40+ y.o., I will pay little extra 13,70chf but my younger wife quite more with 15,70chf/month.

It is interesting as you will get a coverage on drugs prescribed but not covered by the base.

You could also get covered for DENTAplus Assurance soins dentaires for 6.20 chf / monh / kid to cover health check and hygienist visit. I do not think it is interesting as it is not the most expensive treatment and capped for a max of 1k/2k by year.

For adult, it will reach even 34chf/month.


Assura
Admission without dental examination for children under five years of age.
Coverage of 75% of all orthodontic treatment costs, including laboratory and X-ray costs (max. $10,000 per year, depending on the level of coverage).
Three levels of coverage available: $2,000, $6,000, or even $10,000, allowing you to choose the one that best suits your expected orthodontic costs.
Coverage for services in countries bordering Switzerland (Germany, Austria, Italy, Liechtenstein, and France) up to the maximum cost they would have incurred in Switzerland.

  • Denta Ortho: 75% per year, max. CHF 6,000, no deductible = CHF 27.50/month, CHF 330/year, CHF 4,950/15 years
  • Denta Ortho: 75% per year, max. CHF 10,000, no deductible = CHF 35.50/month, CHF 426/year, CHF 6390/15 years
    No dental declaration, age bracket.
    12-month waiting period before age 5.
  • Denta Sana: Scaling, cavities = 4 CHF/month, 48 CHF/year, 720 CHF/15 years
    6-month waiting period.

For adults:
For supplemental coverage:
Complementa Extra: 17.50 CHF/month, /year
Mondia Plus: 6.00 CHF/month, /year
Denta Sana: 34.50 CHF/month.


KPT
Details “Benefit class 4” Cp 4 from age 5
75% contribution to costs up to a maximum of CHF 2,000 per calendar year from age 21
75% contribution to costs up to a maximum of CHF 10,000 per calendar year for orthodontics from age 21
Contribution towards dental treatment, adjustment and correction of tooth positioning
75% contribution towards the costs of tooth positioning correction with no limit on the amount after the age of 20

The premium for your supplementary insurance is calculated according to your age. In general, moving to a higher age group results in an increase in the premium. This takes place on January 1 of the year in which you reach the age that determines the change of group.

For CP 0–4, the age groups are as follows:
0–5 years; 6–10; 11–18; 19–25; 26–30; 31–35; 36–40; 41–45; 46–50; 51–55; 56–60; 61–65; 66 and over.
0-5: 9.40 CHF; 6 years + 28 CHF/month, 11 years 47 CHF, 20 years+: 30 CHF = Total = 7,433 CHF = 113 CHF + 1,680 (336**5) + 5,640 (564**10)


CSS
Dental insurance
Contribution to the costs of dental treatment. No health questionnaire for 3 years.
30.70 CHF
Dental insurance covers costs that are not covered by basic insurance and protects you from the financial consequences of dental treatment.

Treatments such as dental hygiene, X-rays, fillings
Orthodontic treatments and check-ups
Dental prostheses such as crowns or pivot teeth

Cost coverage / year
75% per year, max. 6,000 and deductible of 500 CHF = 30.70/month, 368 CHF / year, CHF 6,256 / 17 years old
75%. max. CHF 3,000 max. and no deductible = CHF 51.70/month, CHF 621 / year, CHF 9,936 / 16 years old

  • Compulsory outpatient insurance myFlex up to age 15 = CHF 11.50/month, 138 CHF/year, 2208 CHF/16 years
    Balance Dental treatment for 50%, max. CHF 1,000/year
    Teeth straightening 50%, max. CHF 12,000/year
    Total = 12,144 CHF/16 years
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We’re expecting our first child at the end of the year, and the headache of comparing supplementary health insurance plans has already begun :smiling_face_with_tear:.

I’m currently leaning toward CSS or SWICA, although I don’t have any particularly strong experience or preference for either. I was insured with CSS as a child and never had any issues. As an adult, I’m with SWICA, but I haven’t really had the opportunity to use their services so far.

What are your experiences and recommendations regarding supplementary insurance coverage for a newborn?

Is basic mandatory health insurance (LAMal) plus dental coverage a good starting point, or are there other supplementary plans you would consider worthwhile from birth?

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Congratulations !
There is no rush to subscribe to any dental insurance or complementary insurance for your newborn. Almost everything is covered under 4 years old.
I will register my son to Helsana TOP for 2458 chf spread on 16 years (from age 4). I have also subscribe to Helsana TOP for my wife and me.

I have made a detail comparison with CSS and others on the thread above. With CSS,you will pay 12,144 CHF for 16 years the most expensive for the same coverage.

I haven’t compare to SWICA so if you can share your findings on their coverage until your child is 20 y.o., it will interesting to compare with Assura and KPT.

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Wait, you can buy/hedge a child’s health insurance over 16 years? :hushed_face:

I have the same questions. For newborns you don’t need to immediately take dental coverage. At least with Helsana, they accept children under the age of 3 for dental coverage without any examinations. I am currently wondering if it is worth it to take one of the DentaPlus packages from Helsana. Orthodontic stuff (the expensive stuff) is already covered by one of the supplementary insurances (COMPLETA) our child has, therefore I am not sure the DentaPlus packages are really worth it: they would cover additionally check-ups, hygienist, dental caries and things like that. Not sure if it is really worth it. The premium for a 3-year old is quite low, but then increases with the age.

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All insurers got various pricing model so it makes sense to compare them all until the end of the coverage.
This is why I did the previous calculation from 3 y.o. until 20 y.o.

For Helsana, if I remember correctly you need to subscribe to Helsana TOP for 13,30chf/month.
I did not subscribe for DENTAplus Assurance as this maintenance cost should not skyrocket at the opposite of orthodontist.

The sales person that help me compare them all told me the pricing of TOP is fixed until adulthood. (2554 chf for 13,30 * 12 * 16).
I will let you know if the coverage is efficient in 7-10 years from now 


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See AGB:

Helsana kann PrÀmientarif, PrÀmienrabatte, Franchise oder Selbstbehalt aufgrund der Kostenentwicklung, des Schadenverlaufs sowie wegen Anpassung des Deckungsumfanges jÀhrlich neu festlegen.

Yes this is inflation upgrade but the yearly price is flat at the opposite of other models like KPT.

Thanks :smile: !

I was also able to check some of the data, especially regarding SWICA. I found that the Kassensturz study gives quite useful information, even though it is from 2020 and in German:

I’m thinking of going with SWICA Completa TOP exclusively. The cover already seems very comprehensive to me, and it will also allow me to simplify things by having everything with a single insurer.

What will be the overall cost for this cover until your newborn will be 20 y.o. ?
What will be the maximum amount covered on a specific year ?

Sum up from Claude :

SWICA does not use a single 75% rate. The reimbursement rate and cap depend on the product/level, and apply per calendar year up to age 25 for orthodontics (not 20). Completa Top already includes an orthodontic benefit; Denta mainly adds routine dental cover and a higher rate. SWICA recommends taking out Denta alongside Completa Top by the child’s 5th birthday. No health declaration if the baby is enrolled at birth (newborn window); otherwise a health questionnaire applies. Orthodontics is reimbursed at the UVG/LAA tariff.

Completa Top (general outpatient supplement, accident incl.)
Dental treatment + hygiene: 50% up to CHF 100/year.
Orthodontics: 50% up to CHF 10,000/year, up to age 25 (UVG rate).
Child co-payment: no excess under 18; 10% deductible, max. CHF 350/year.
= CHF 8.90/month, CHF 106.80/year, CHF 1,708.80/16 years (age 4→20)
(over the real ortho window to age 25: ~CHF 2,136/20 years)

SWICA is way cheaper but you will pay 50% of the orthodontics bill.
All the other providers comparison cover 75% of the cost.

CSS is also at 50% (max 12k) with myFlex Balance ambulatory.

I have the feeling that the Dental supplemental insurance, égal which provide, is not really needed, or only to cover some special dental disease.

For pure orthodontics treatment (braces, expanders, etc) most of the company includes the coverage in on of their pack.