The scope of benefits
What does supplementary dental insurance pay?
It complements your statutory health insurance. Different conditions apply to a crown than to teeth cleaning or braces. A high reimbursement for dentures does not tell you what the plan pays in the other areas.
Dentures and implants
Crowns, bridges, and dentures are core components of many plans. For implants, the costs for the abutment and crown are also covered. Whether necessary bone grafting is included is specified separately in the terms.
Look closely: number of implants, material and laboratory costs.
Dental treatment
Fillings, root and periodontitis treatments fall into their own service area. A tariff can reimburse additional private costs or include treatments for which the health insurance company does not pay in the specific case.
Reimbursement for dentures does not automatically apply here.
Professional dental cleaning
The Professional Dental Cleaning (PZR) is not a mandatory service under statutory health insurance. Some providers offer voluntary subsidies. Dental insurance plans often include maximum annual or per-cleaning reimbursement limits.
Take the existing cash subsidy into account when comparing.
Orthodontics
For braces, your policy must include a suitable add-on. Age limits, requirements, and reimbursement amounts may differ for children and adults.
Also check for minor misalignments and private additional services.
The basis of the bill
What statutory health insurance pays for dental prosthetics
The fund contributes with a fixed subsidy based on the findings. The starting point is the fixed costs of the Standard care: medically adequate, appropriate and cost-effective treatment for your diagnosis.
The subsidy is generally 60 percent of these costs. With proven regular preventive care, it increases to 70 percent after five years and to 75 percent after ten years. The evidence required also depends on age.
If you choose an implant instead of a bridge, the subsidy does not simply increase with the higher bill. The statutory health insurance continues to subsidize standard care for the diagnosis. Implantation itself is only covered by statutory health insurance in rare, severe exceptional cases.
- Without preventive care bonus60 %
- With 5 years of proof of pension provision70 %
- With 10 years of proof of pension provision75 %
Share of the specified costs of standard care for the diagnosis. Not on any dental bill. Requirements according to § 55 SGB V.
Read percentages correctly
How much out-of-pocket cost remains despite insurance?
For many tariffs, the cash subsidy is already included in the advertised reimbursement. If it says “80 percent including GKV,” the fund and additional insurance together cover 80 percent of the refundable invoice amount. 20 percent stays with you.
Other plans reimburse a portion of the remaining out‑of‑pocket cost or a multiple of the fixed subsidy. The same percentage may therefore result in a different payout.
There are conditions even with 100 percent cost coverage
First, check which invoice items are eligible for reimbursement. Possible caps on fees, materials, and laboratory costs, as well as the dental benefit schedule (Zahnstaffel), may also apply. For planned treatments, have the expected reimbursement confirmed based on the treatment and cost plan.
Select an example reimbursement including statutory benefits:
- Cash register and additional insurance together
- 80 %
- Your own contribution
- 20 %
Assumption: The entire invoice is reimbursable, no further limits apply. Dental fee schedule, fee or material limits can increase the actual out‑of‑pocket share. The graphic does not calculate any contribution.
Your contribution
How much does additional dental insurance cost per month?
Your entry age and the benefits you choose play a significant role in determining the contribution. Depending on the provider, missing teeth can mean surcharges or exclusions. In the dental supplement comparison you can see which monthly contributions apply to your information.
Also consider future premiums. Some plans become more expensive when you move to a higher age group. Others use age-related reserves. Premium adjustments due to increased benefit costs are possible under both models.
If your main concern is teeth cleaning, calculate the annual premium against your PZR budget and your health insurer’s contribution. Taking out insurance solely for this may not be worthwhile. Dental implants involve a different financial risk.
Compare my premiumFor a useful price comparison
These information belong together
- Age at start of contract
- The entry price applies to a specific person.
- Desired benefits
- View dental prosthetics, preventive care, and orthodontics separately.
- Condition of the teeth
- Existing gaps or findings can change the underwriting decision.
- Future contributions
- Read along with the planned development by age group.
Before choosing a tariff
Comparison of supplementary dental insurance
Anyone wanting to cover implants needs different priorities than parents concerned about braces. Therefore, first determine which benefits are important to you. Then compare tariffs with similar coverage and read the full terms and conditions for your favorites.
- What the quota refers to
- To the reimbursable invoice amount, the co-payment, or just the statutory health insurance subsidy? Is the statutory health insurance benefit already included? Only with this information can percentage values be compared.
- Implants and dentures
- Pay attention to the number of insured implants, bone augmentation, and material and laboratory costs. The insurer's own price list can limit reimbursement.
- Dental practice fees
- Up to what rate in the fee schedule for dentists (GOZ) is reimbursed? An additional personal contribution may remain for a fee agreement that goes beyond this.
- Limits in the first years
- Read the initial dental benefit limits as a timetable. Check whether amounts apply to each year or to several years together and whether the tariff counts calendar years or insurance years.
- Your dental situation
- Missing teeth, existing dentures and treatments that have already been recommended can affect acceptance or protection. The health questions specify what information is required.
- Contribution and contract term
- Also compare later age levels, minimum term and notice period. If you change, a new health check and new benefit limits may apply.
Which supplementary dental insurance is the best?
A test winner can narrow down the search. However, the grade applies to the criteria of the respective test: for a specific model person and a specific weighting of dental prostheses, preventive care or braces. Also look at the test date. The best dental insurance for you must fit your teeth and your budget.
Start of coverage
Supplementary dental insurance without waiting period: What applies immediately?
Without a waiting period, insurance cover can apply from the agreed start date. The dental benefit scale and exclusions for pre-existing conditions still apply. Therefore, you may still have to pay a deductible from day one.
Waiting period
It defines how long you must wait for certain benefits after the contract starts. A plan without a waiting period waives this requirement.
Waiting period schedule
It limits reimbursement in the first few years. With a cumulative limit, benefits already paid are deducted. “Without waiting time” does not remove this limit.
Known findings
Treatments that have already been recommended, planned or begun are often excluded. This can also apply if there is no written cost plan yet.
Answer the health questions in the application completely and truthfully. If you cannot classify a finding, ask your dental practice before submitting the application. An incorrect answer can jeopardize your insurance coverage later.
For parents
Supplementary dental insurance for children: considering orthodontics
For children, it is worth taking a closer look at orthodontics. Whether the health insurance company will pay for braces depends, among other things, on the severity of the misalignment. This is why there are orthodontic indication groups, or KIG for short.
- KIG 1 and 2
- Statutory health insurance generally does not pay for these minor misalignments.
- KIG 3 to 5
- Treatment is medically necessary if it begins before 18. Birthday basically cash benefit.
If health insurance treatment is approved, parents usually present 20 percent of the costs. After the medically necessary completion, the health insurance company will reimburse this portion. Private additional and additional services remain separate from this. Depending on the tariff, additional dental insurance can help with these additional costs or with minor misalignments.
The decisive factors are the maximum amount for the entire treatment, the insured indication groups and the age limits. If braces have already been recommended, it is often too late to secure them.
Different rules apply for adults
The GKV only covers orthodontics in adults in very limited cases, such as severe jaw anomalies requiring combined surgery and orthodontic treatment. Private additional tariffs also often limit this area, for example to the consequences of accidents.
If dentures are planned
The treatment and cost plan makes reimbursement concrete
The plan records the findings, the planned care and the expected costs. After your consent, the practice will send it electronically to the health insurance company. You will receive a summary for your documents.
Discuss the planned treatment
Have the standard care and possible alternatives explained to you. Ask about the respective personal contributions and additional fee agreements.
Request approval for the statutory dental subsidy
Before starting planned prosthetic dental treatment, the statutory health insurance fund must generally determine the fixed subsidy. Exceptions apply for acute repairs; clarify the procedure with the dental practice.
Include the additional insurer
Submit the required documents in advance and ask for written information regarding reimbursement. Ask questions if positions or totals remain unclear.
Submit claims after treatment
Keep the invoice, cost plan, and benefit statement from your health insurance fund. Check the supplementary insurer’s requirements for documents. Always confirm any changes to your treatment plan in advance.
Frequently asked questions about supplementary dental insurance
Who benefits from a supplementary dental insurance plan?
Especially for people who want higher-quality dentures and don't want to cover larger amounts of their own money from reserves alone. If you are satisfied with standard care and can save money for dental treatment, you can also get by without additional insurance. The decisive factors are your needs, the premium over the duration of the contract and the actual insurable condition of your teeth. The policy is not a savings contract.
Does supplementary dental insurance pay for missing teeth?
Teeth that are already missing and not yet replaced can be excluded, can be insured for a surcharge or can lead to the application being rejected. That depends on the tariff. An existing implant or bridge can be classified differently in the application than an unrepaired gap. Answer the insurer’s specific question; If the findings are unclear, asking the dentist's office can help.
What applies to supplementary dental insurance without health questions?
No health questions does not mean that every treatment is covered. Such tariffs can also exclude treatments that are already necessary or have begun and limit their benefits. Therefore, read the insured scope and exclusions just as carefully as you would for a tariff with questions about your dental condition.
Is supplementary dental insurance worth it for seniors?
Age alone doesn’t determine eligibility. Existing dental work (crowns, bridges, prostheses), the acceptance rules of your plan, and premium costs matter. Especially for later enrollment, compare initial coverage limits against ongoing costs. Previously recommended dental work is not covered under a new policy.
Is dental treatment in Poland covered?
This is regulated by the conditions of your tariff. Clarify the geographical scope, invoice and translation requirements and possible fee limitations in advance. Get written information from your health insurance company and additional insurer about the treatment plan. A lower treatment price alone is not a promise of reimbursement.
Can I cancel or switch my dental insurance add-on?
The minimum term and notice period are stated in the contract. Before switching, you should clarify whether the new insurer will accept you on the desired terms and which waiting period schedule starts anew. Treatments that have since been recommended may also be excluded in the new contract. Only cancel the existing protection once the follow-up insurance and its limits have been definitively clarified.
Your comparison
Which benefits do you want to cover?
Compare premiums and conditions for your dental situation. If a clause is unclear, you can ask us about it.
Sources and Context
Content last updated: . General information for people with statutory health insurance, not an individual promise of benefits. The respective contract and the assessment of the specific case are decisive.
- Consumer advice center: Supplementary dental insurance – risks and benefits (opens in a new tab)
- § 55 SGB V: Fixed grant, bonus and hardship regulation (opens in a new tab)
- § 28 SGB V: Dental treatment and benefit limits (opens in a new tab)
- § 29 SGB V: Orthodontics and personal contribution (opens in a new tab)
- § 19 VVG: Information on the insurer's questions (opens in a new tab)
- KZBV: Bonus booklet and preventive care (opens in a new tab)
- KZBV: Dental prosthetics from application to billing (opens in a new tab)
- Federal Joint Committee: Orthodontic guidelines and indication groups (opens in a new tab)
Already have private health insurance? First, check your existing dental benefits private health insurance plan (PKV).