By taking out additional health insurance, the insured person has the opportunity to receive quality medical care in many areas. The list of the most common conditions under a voluntary medical insurance (VHI) policy includes dental services. You will find out below what manipulations and procedures are provided by the VHI dentistry option.
What is this: a dental policy for individuals?
Not only employers pamper their employees, but also citizens themselves, uniting in groups or independently purchasing a voluntary health insurance policy.
Often, a VHI policy is purchased primarily to obtain dental services.
Dental treatment is expensive, and those who are faced with this problem have the opportunity to save significantly with the help of insurance.
Let's look at the types of VHI insurance for dentistry.
Corporate program
This insurance option can be considered voluntary. This is explained by the fact that the employer, by agreement with the employees, insures them.
Basically, medical insurance provides a standard package of services offered, changing in accordance with the wishes of the customer.
In order to reduce the cost of employee insurance, an entrepreneur can use different options. One of them is the employee’s shared participation, when he pays for part of the services himself or a certain amount is debited from his salary (only on the basis of voluntary consent).
More information about employee insurance ►►
Individual program
Emergency dental care may be included in the basic VHI package.
Individual policy formation may depend on the position, labor productivity and other factors (elite programs, standard, basic).
Collective program
In large cities, group insurance is especially common.
Individuals, united in a group of 15-20 people, jointly submit an application to the insurer.
This option allows you to save a decent amount when obtaining a policy.
What else may be included in the program ►►
The insurance company may make a semi-formal offer to join an existing insurance policy.
Types of implantation
There are 7 types of dental implantation:
- Intraosseous – installation is performed in the bone tissue, due to which the structure takes root well. When the alveolar process is small, osteoplasty is performed. This type is the most popular and developed throughout the world.
- Basal – if the volume of bone tissue in the jaw is minimal and it cannot be increased, then this technology is used. Installation is carried out in the hard and deep layers of the jaw bone tissue. It is often combined with the fixation of bridges.
- Endodontic-endosseous is an old technology used to protect the tooth root. The structure was installed through the dental canal, so there was no need to injure the gums. Nowadays, endodonto-endosseous is not used.
- Subperiosteal is an outdated technology in which the structure was attached under the periosteum.
- Intramucosal – used to improve the quality of removable prosthetics. The attachment of removable dentures is significantly improved, even in severe pathologies.
- Transosseous is an outdated and dangerous technology that was used to fix implants in the lower jaw. The operation was cheap and often resulted in injury to the mandibular nerve.
- Laser is a modern technology that uses a laser instead of a scalpel. This allows you to reduce the amount of painkillers and perform the operation much faster. An additional advantage is the absence of seams.
What is included in dental insurance?
Dental services are not included in the main VHI program. They are an addition to it in accordance with the wishes of the policyholder.
As part of this policy, the dentist examines and diagnoses the oral cavity. X-ray and other required examinations are also provided.
Having a policy, you can receive therapeutic treatment (canal filling, fillings, caries treatment).
This list includes surgery that involves the removal of incisors and benign formations.
The policyholder has the right to treat the gums, undergo aesthetic treatment, which includes removing stones, and applying fluoride-containing varnishes to the enamel.
The insurance holder is provided with 24-hour assistance at the clinic.
What do you have to pay for out of pocket?
When signing a contract, the policyholder cannot foresee various cases that will not be included in the insurance.
Thus, additional medical dental care services may include teeth whitening, replacement of fillings, prosthetics, and more.
These include orthodontics and periodontal treatment.
Generally, such services are considered to be cosmetic services, and they are not provided for in the VHI policy.
Is everything possible to include VHI?
But the history of personal insurance in the Russian Federation is not what interests the domestic insurer. It is important for him to understand what is included in the VHI, whether he can take into account prosthetics services in the policy. The answer is yes: prosthetics can be included in the contract with the insurer, but with some reservations:
- as a rule, insurance companies agree to take on such an expensive risk only as part of dental services: coverage includes dental prosthetics with preparation for procedures;
- in 99% of cases, voluntary health insurance with prosthetics is a premium price class program, extended insurance, which not everyone can afford;
- on the Russian market, only large serious insurers take prosthetics into account in their programs.
And the insurers, in a sense, can be understood. The logic of their reasoning is transparent: if a person wants to include such complex treatment in his policy, then he suspects that he will need it. That is, he knows things about his health that he does not tell his insurance partner.
And this already amounts to fraud. You cannot insure yourself to solve an old health problem; VHI insurance is purchased for unforeseen cases of illness.
Is it possible to insure teeth: what are the features?
Additional medical insurance is a priority for large holdings with large staff.
Service under a VHI policy is not “geographically” convenient for everyone.
This is due to the fact that dental services are provided in only a few medical clinics located in different parts of the city.
This type of insurance usually has limitations.
Over the course of 12 months, the policy provides for treatment of only two teeth.
It is provided when the patient has average caries and the crown is 50% destroyed. Other services are paid for, but they are subject to a discount.
Experts note that situations cannot be ruled out in which the insured person will have to spend a long time sorting out relations with the insurance company.
We offer to compare compulsory medical insurance and voluntary medical insurance ►►
They arise when, over the course of a year, more people from the company visit the clinic than are stipulated in the contract. In this situation, many patients are billed in full for services.
Corporate insurance is especially beneficial for employees of hazardous enterprises.
Especially in those enterprises where, in the course of performing their official duties, they have to deal with abrasives and chemicals.
Receiving treatment within the framework of VHI dental health insurance is of better quality than free compulsory medical insurance.
And it’s certainly more profitable than visiting a dentist individually at your own expense.
Cost of VHI for dentistry in 2022 in the top 5 insurance companies
Some top insurance companies with high reliability ratings do not provide standard programs for individuals for VHI insurance with the option of dental services. For example, those insured who have dental treatment under the policy of VTB or SOGAZ either have corporate insurance or negotiate the terms of insurance individually. The table shows the prices of those organizations that have standard programs that include dental services.
| No. | SK name | Name of the program taking into account the Dentistry option | The cost of the condition under the VHI policy |
| 1 | RESO | Standard | 8540 rub. |
| 2 | Renaissance | Optima | 7926 rub. |
| 3 | Rosgosstrakh | Basic | 6334 rub. |
| 4 | Ingosstrakh | Standard | 5448 rub. |
| 5 | VSK | Standard | 5236 rub. |
Underwater rocks
Before making a decision regarding insurance, you need to familiarize yourself with all the nuances.
One of them is the inability to change clinics at your own discretion.
In accordance with the terms of the contract, services during the insurance year are provided exclusively in the medical institution that is selected upon receipt of the policy.
Find out about the VHI Agreement ►►
The clinics do not provide services to specialized specialists, such as an orthodontist and prosthetist. Their services are not included in the policy.
It is important to know that diagnostic examinations are recorded in the policy.
By signing an agreement with a franchise, the insurance premium is slightly reduced. This amount increases when an insured event occurs. Partial treatment will have to be paid from your own funds.
When you have chronic diseases, you won’t be able to apply for voluntary health insurance ; they refuse to do so.
It is impossible to hide such a fact, since if it is revealed, you will have to pay a fine and reimburse all spent financial resources.
Another problem is that insurers prefer corporate insurance. They often refuse to issue VHI to individuals.
It is difficult to find companies that agree to cooperate with individuals.
Advantages of voluntary health insurance
The advantages here are the same as those of paid treatment over free:
- Service in private clinics with a higher level of comfort and technical equipment.
- No queues.
- Quality service. This includes the polite treatment of the staff and such little things as free shoe covers and other disposable consumables.
In addition, the patient pays for the VHI policy once, and then the insurance company reimburses the costs to the medical institution. This approach reduces the number of unnecessary examinations and prescriptions that doctors sometimes do in paid centers: the insurance company simply will not approve manipulations that are not part of the standard of treatment.
Is there a program with dental prosthetics?
Dentistry medical insurance in its basic version does not include dental prosthetics. This is due to the high cost of implants. Moreover, they are often made of expensive ceramics or precious metals.
However, in premium and expensive programs, dental prosthetics can be added as an option. But here, too, the client faces restrictions.
For example, it turns out that the contract will stipulate the condition for the need for a prosthesis due to maxillofacial trauma, and not due to untreated caries.
The cost of the program with dental prosthetics included in the package will start from approximately 140,000 rubles / year.
What insurance doesn't cover
All insurance companies have different conditions. It is possible that your contract for a certain price will contain something that is not in other contracts. But standard policies are the same in most cases. In addition to the already indicated cases of HIV infection and malignant neoplasms, they do not cover the costs of:
- Medicines. You will have to buy tablets with your own money.
- Preventative visits to the doctor. Let's say nothing bothers you, but you know that you need to visit the dentist and gynecologist every year or even twice a year. If you take care of yourself, the doctor will confirm that you are healthy. And this appeal will not be considered an insured event. The same can be said about visiting a doctor when you need to get a stamp on a certificate, for example.
- Pregnancy and childbirth. These events are not considered an insured event, and insurance companies and clinics have separate offers for medical support of pregnancy.
- Psychiatric help. You will talk about stress, burnout and depression with a psychotherapist at your own expense.
It’s easier to say when a basic policy works: when you got sick, you went to the doctor and were treated on an outpatient basis. Everything else, including hospitalization (in a comfortable room), is additional chips for additional money.
Analysis of services and cost of insurance in different companies
VHI insurance with the “Dentistry” option is issued by the insurance company.
In order for cooperation to be profitable, it is necessary to consider the conditions and costs of various insurers.
Based on the data obtained, you can choose the best option that will satisfy all aspects.
To purchase a VHI Dentistry policy, you should visit the office of the insurance company.
In some insurance companies, the application can be left by the user on the website.
The policyholder must provide a list of documents, including an identity card, SNILS and confirmation of registration. The company will also ask you to fill out an application.
To obtain a policy, at the request of the insurer, you must undergo an examination. The client can decide on the program for dental services.
After this, the contract is signed and payment is made. After completion of all actions provided by the insurance company, a policy is issued.
Read more about VHI for individuals ►►
SOGAZ
This program involves cooperation with leading dental clinics near and far abroad.
Supervising doctors conduct consultations with clients regarding medical services and monitor the progress and quality of treatment.
The medical contact center operates around the clock and maintains contact with medical institutions.
Monitoring of the implementation of services under the insurance program is carried out.
Qualified specialists will promptly resolve any customer issues.
RESO
The most popular service is dental surgery.
Surgical dental treatment includes tooth extraction , cyst removal, and opening of abscesses that occur in the maxillofacial area.
Provides assistance in relieving acute conditions in periodontal diseases.
Within the framework of the program, cooperation is carried out with private dental clinics, to which the insured can apply.
Alfa insurance
Obtaining a policy from Alfastrakhovanie involves providing the insured person with qualified dental care.
The insurance holder has the right to visit a physician and surgeon.
The policy includes dental radiography and electrodontodiagnosis.
Typically, the cost of a voluntary health insurance policy with dentistry starts at 20,000 rubles/year.
Also, the policy holder is given the right to receive therapeutic dentistry (treatment and filling of carious cavities and canals).
Preventive measures are provided, which consist of removing supragingival dental plaque.
Ingosstrakh
Provides for the conclusion of comprehensive policies for treatment at the Zub.ru dental clinic.
These programs can treat periodontal disease, diagnose and treat the salivary glands, which is considered a rarity when concluding dental insurance.
The cost of services is cheaper (maybe 50%) than in other clinics and starts from 7,000 rubles / year for adding dental treatment services to the standard VHI program.
Since the cost of Dentistry insurance under VHI for individuals is calculated individually, you should definitely contact each insurance company in your city for a detailed price calculation.
How to understand whether it is worth buying a VHI policy
To find out whether it is worth buying a policy, you need to do a little:
- Calculate how much you spend on treatment.
- Find out what service packages you need.
- Check which insurance companies provide the policy and for what amount.
Last year, I didn’t spend much on treatment in commercial clinics and sought help mainly for preventive examinations (the table shows rounded data, prices are relevant for my region):
| Service | Cost, rub.) |
| Gynecologist appointment | 2 300 |
| Analyzes and examinations | 3 750 |
| Medical procedures and treatment | 4 540 |
| Preventative dental examination | 150 |
| Professional teeth cleaning | 3 000 |
| Massotherapy | 8 000 |
| Consultation with a therapist | 550 |
| Medicines | 4 724 |
| Total | 27 014 |
A calculator from one of the insurance companies calculated that the minimum policy, which would include dental services, would cost me 35,000 rubles per year. At the same time, I will also spend money on treatment, because all prevention, if you believe the insurance rules, will fall entirely on my wallet. That is, massage, teeth cleaning and medicine purchases - the most expensive items on my list - will remain outside of insurance.
You can purchase a policy that will cover these costs. But its price will be sky-high - under a hundred thousand rubles.
Out of curiosity, I called two more insurance companies, where honest employees directly said that for individuals, the VHI policy is unprofitable, and if you are worried about the risk of injury or illness, then it is more logical to conclude an insurance contract against accident or illness: it is several times cheaper .
Which dental clinics provide treatment under the compulsory medical insurance policy?
If you have a question about the possibility of treatment under the policy, you can contact the registry of the selected institution or look for information on the official website. Private companies from among the program participants are required to post information about the provision of services within the framework of compulsory medical insurance (with a list of types of assistance provided) in the public domain. Cases of violations of this requirement can be reported to Roszdravnadzor. You will find a complete list of commercial companies willing to provide services for free in the register of medical organizations on the website of the territorial compulsory medical insurance fund of your locality.
