The Helsana Group comprises Helsana Insurance Company Ltd,

Helsana Supplementary Insurance Ltd and Helsana Accidents Ltd.

Edition 1 January 2009

Additional Insurance Conditions (ZVB)

DENTAplus – the flexible dental insurance for any need

List of Contents 4 Commencement of benefits

Entitlement to DENTAplus benefits shall begin after a
General Provisions
waiting period of 6 months following the commence-
1 Purpose
ment of the insurance. The date of treatment shall give
Benefits rise to entitlement.
2 Insurance cover
3 Benefit conditions 5 Benefit exclusions
4 Commencement of benefits 5 .1 In addition to the exclusions of benefits listed in
5 Benefit exclusions Section 21 of the General Insurance Conditions (AVB)
for Supplementary Health Insurance (KVZ), no benefits
Miscellaneous
shall be paid in the following cases:
6 Insurance for children
a) replacement of teeth which were missing,
7 Annulment of premium limits
replaced or retained at the time of the stipulation
of the (DENTAplus) policy;
b) dental treatment due to accident;
Translation: Only the original German text approved c) loss of or deliberate damage to replacement teeth or
by the Swiss Supervisory Authority is binding. orthodontic devices.

5 .2 Payments for school or youth dental care are covered

General Provisions
by benefits.
1 Purpose
DENTAplus shall grant benefits covering the cost Miscellaneous
of dental treatment, including preventative treatment,
6 Insurance for children
dental check-ups, orthodontics and maxillofacial
Children can be insured from birth, provided the
­surgery.
­proposal for the insurance is received by the insurer
prior to the birth. In this case, no benefit exclusions
Benefits
will be applied to the DENTAplus Dental Insurance in
2 Insurance cover the event of any pre-existing damage to health.
DENTAplus shall assume the costs of treatment
in accordance with the maximum allowable amount 7 Annulment of premium limits
selected, less the excess and deductible. The maxi­­ The premium limits set in Section 12.2 of the General
mum allowable amount, excess and any deductible Insurance Conditions for Supplementary Health
will be listed in the insurance policy. Insurance, Edition 1 January 2008, do not apply for
the insurance plan DENTAplus Flex.
3 Benefit conditions
3 .1 DENTAplus benefits are for treatment by federally
­certified dentists or those accredited under cantonal
regulations.

3 .2 In the case of treatments abroad, costs shall be cov-

ered if the foreign dentist has completed professional
training commensurate with that of Swiss dentists.

3 .3 Benefits paid shall not amount to more than the

­currently valid fee set out by the Swiss Dental
Association (SSO). The SSO fee is considered to
be the upper limit in case of treatments abroad.

3 .4 In the event of an inpatient hospital stay in

Switzerland, benefits shall be paid as customary
2111_Vers_DENTAPLUS_2009_en

in the general ward.