If you have statutory health insurance, many services provided by your dentist are free of charge for you and are billed via your electronic health card (eGK): This applies, for example, to the removal of caries and the filling of holes.

Additional cost regulation for dental fillings

You are entitled to fillings made of the least expensive material. In addition to this standard treatment, you can also choose other materials. In these cases, you will only have to pay the additional costs incurred privately.
If you choose a more expensive material, for which you pay part of the costs yourself, you conclude a so-called additional cost agreement with your dentist. Your dentist settles with the health insurance company the benefits to which you are entitled according to the standard care. You will receive an invoice from your dentist for any additional services.

Allowance for dentures

For dental prostheses (e.g. crowns or bridges), your health insurance fund will provide you with precisely defined amounts as fixed allowances. The amount of the fixed subsidy is 60 percent of the average costs for standard care and can increase to 70 or 75 percent if you have had regular checkups in the last 5 or 10 years before treatment begins and the checkups are documented in your bonus booklet.

Costs that exceed the legally regulated reimbursement amount must be borne by you. Your health insurance company may cover a further amount of the costs if you have only a low income or receive certain social benefits (for example, BAföG, social assistance or unemployment benefit II).

If you have private supplementary dental insurance, you may - depending on the contract - be able to submit additional cost invoices, co-payment invoices and private invoices there. In any case, it is recommended that you inform your private supplementary insurance company before treatment begins and clarify what must be taken into account for any possible reimbursement or which documents are required for this.

Orthodontics

You or your child are entitled to orthodontic treatment if there is a medically justified indication and you or your child have not yet reached the age of 18 when treatment begins. Adults usually have to pay for orthodontic treatment themselves. Only in medically justified exceptional cases, for example in the case of severe jaw anomalies where surgical corrections are also necessary, can insured persons over the age of 18 also be entitled to benefits.

Dental implants

You must also bear the costs of a dental implant and the implant surgery yourself. Only in severe and special exceptions does the health insurance fund contribute to implants, for example as part of an overall medical treatment after a tumor operation.