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Dental treatments

How much of my dental bill will ÖKK pay?

With a few exceptions, dental benefits are not part of the basic insurance plan (KVG). If, however, you have taken out a separate dental insurance plan with ÖKK, we will naturally take over all treatments within the sums insured. Tooth brushes, tooth paste, etc., are of course excluded.

Why does the basic insurance plan not pay anything for dental treatments, especially for wisdom tooth extraction?

The mandatory health insurance policy (basic insurance) only covers dental treatment if diseases of the masticatory system or general illnesses are involved. With ÖKK SMILE you can close your gap in coverage for dental treatments. ÖKK START covers the costs for wisdom teeth extraction.

Does ÖKK pay anything towards dental hygiene?

Regular examinations of your teeth by the dental hygienist are generally not standard benefits and cannot be covered by the mandatory health insurance policy (basic insurance). For children and young persons up to 25 years of age, ÖKK START supplementary insurance pays 60 francs per year towards check-ups and prophylaxes. With ÖKK SMILE dental insurance, this amount rises to 100 francs per year (in addition to the benefit from ÖKK START).

Does the basic insurance plan include caries treatment as a standard benefit?

The basic insurance covers treatment costs arising from caries if in direct relation with a general illness covered by the basic insurance plan. 
We recommend clarifying before the treatment what benefits you can claim within the limits of your insurance coverage.

I have tooth damage due to an accident. What coverage do I have?

If tooth damage is caused by an accident, the mandatory health insurance policy (basic insurance) will cover the costs, as long as no other accident insurance exists (e.g. employer's accident insurance). Even if no damage to the masticatory system is determined at first, it is important to inform the health insurance provider of the accident in case damage appears later.

How much does ÖKK pay towards braces?

For orthodontic treatments, ÖKK covers the following costs (according to social insurance tariff):

ÖKK START supplementary insurance:

70%, up to CHF 10,000 per calendar year, incl. neighbouring countries of Switzerland (up to 25 years of age)


ÖKK SMILE supplementary insurance:


 Options
 Insurance cover per calendar year
 SMILE 1'000  50%, up to CHF 1,000 per calendar year, incl. neighbouring countries of Switzerland*
 SMILE 1'500  75%, up to CHF 1,500 per calendar year, incl. neighbouring countries of Switzerland*
 SMILE 3'000  75%, up to CHF 3,000 per calendar year, incl. neighbouring countries of Switzerland*
 SMILE 5'000  75%, up to CHF 5,000 per calendar year, incl. neighbouring countries of Switzerland*

 

* In addition to benefits from ÖKK START