The dental benefits of private health insurance range from preventive care and fillings through root canal treatment to dentures and implants. Only the tariff determines how much of this is reimbursed, and the differences are large. In statutory health insurance (GKV), the fixed subsidy (Festzuschuss) for dentures is 60 percent of the standard care (Regelversorgung) in 2026. From 1 January 2027, a reduction to 50 percent has been decided.
The key points in brief
- Dental treatment (for example fillings) and dentures (for example crowns) are billed separately and are often reimbursed differently in the tariff.
- For dentures, statutory insurance pays a fixed subsidy: 60 percent of the standard care in 2026, and 50 percent is decided for 2027.
- Many private tariffs limit reimbursement for dental benefits in the first years of cover (dental scale, Zahnstaffel).
- Preventive care, implants and orthodontics for adults depend on the tariff: check the quota, maximum amounts and waiting periods.
- The exemption from compulsory insurance during your studies applies for the entire course of study and cannot be revoked.
What is the difference between dental treatment and dentures?
Dental treatment includes fillings, root canal treatment, the treatment of gum disease such as periodontitis, and tooth extraction. Dentures replace missing or destroyed teeth: crowns, bridges, dentures and implants all count as dentures.
The distinction matters because tariffs regulate the two separately. A tariff may reimburse dental treatment generously and set maximum amounts for dentures. Inlays, which are more elaborate filling inserts made of ceramic or gold, also depend on the tariff. For this reason, check the conditions to see under which section the tariff lists them.
What does statutory health insurance pay for dentures?
The GKV does not pay a percentage of your bill, but a fixed subsidy. It depends on the dental findings and is based on the standard care, that is, the medically necessary standard solution. In 2026, it amounts to 60 percent of the standard care. With a bonus booklet that is kept up without gaps, it rises to 70 percent after five years of regular check-ups and to 75 percent after ten years.
For 2027, it has been decided that the fixed subsidy will fall to 50 percent. Treatment plans approved by 31.12.2026 keep the previous rules. Anyone receiving BAföG falls under the hardship rule and receives 100 percent of the standard care. The current fixed subsidy amounts are published by the National Association of Statutory Dentists (Kassenzahnärztliche Bundesvereinigung).
If you choose more than the standard care, for example an all-ceramic crown or an implant, the fixed subsidy stays at the level of the standard care, and you bear the rest yourself. This is exactly where private tariffs differ from the GKV.
What remains as your own share for a crown?
Example with freely chosen assumptions: the standard care for your findings costs €500. You opt for an all-ceramic crown, which the dentist bills at €1,100. We leave the bonus booklet out of the picture. As the private tariff, we assume one with 80 percent reimbursement for dentures and no maximum amount.
| Insurance | Bill | Reimbursement | Own share |
|---|---|---|---|
| GKV 2026 (60% of €500) | €1,100 | €300 | €800 |
| GKV 2027 (50% of €500) | €1,100 | €250 | €850 |
| Private tariff with 80% reimbursement | €1,100 | €880 | €220 |
The figures show the calculation logic, not tariff values. The amount of the bill depends on the dentist and the material. For an overall view of costs at the dentist as a privately insured patient, see costs at the dentist as a privately insured patient (in German).
Which dental benefits does private health insurance cover?
This depends on the tariff. The table shows which questions to clarify in the tariff for each area of benefits.
| Area of benefits | What matters in the tariff |
|---|---|
| Preventive care and professional teeth cleaning | How often per year, which maximum amount, does it count towards the dental scale? |
| Fillings and inlays | Including tooth-coloured and ceramic materials, reimbursement rate |
| Root canal treatment, periodontitis | Reimbursement also for more complex procedures, follow-up preventive care |
| Crowns, bridges, implants | Rate, maximum amounts, number of implants, material and laboratory costs |
| Orthodontics for adults | Whether it is included in the tariff, and under which conditions |
| Acute toothache | Emergency treatment, rules for accidents |
For acute complaints outside surgery hours, the dental emergency service helps. For the cost question in emergency rooms and emergency doctor call-outs, see emergency care in private health insurance (in German).
What does a dental scale mean in private health insurance?
A dental scale, also called a sum limit (Summenbegrenzung), limits reimbursement for dental benefits in the first years of cover to maximum amounts that rise over time. The purpose: nobody should switch to a tariff shortly before a major treatment and have the costs reimbursed straight away.
For you, this means that even a tariff with a high reimbursement rate may only pay up to the maximum at the start. Ask how long the scale applies, how high the amounts are each year and whether accidents are excluded. Some tariffs also provide for waiting periods. This too is set out in the tariff conditions.
Does private health insurance pay for preventive care and professional teeth cleaning?
Many tariffs reimburse preventive care, but not all of them, and not to the same extent. What matters is the number of reimbursable teeth cleanings per year, the level of reimbursement and whether the costs count towards an annual maximum amount. For this reason, read the conditions carefully before you rely on preventive care as a benefit.
What should you look for in tariffs with dental benefits?
- Reimbursement rate for dental treatment and dentures
- Annual maximum amounts and the dental scale
- Waiting periods and exceptions for accidents
- Reimbursement of implants, material and laboratory costs
- Preventive care: frequency and maximum amount
- Orthodontics for adults
The more dental benefits a tariff covers and the higher its rates, the more this is usually reflected in the premium. An overview of the amounts is given in the article on the premiums of private health insurance (in German). Which other areas a tariff regulates is shown in the overview of what private health insurance covers (in German).
Is private health insurance worth it for students because of dental benefits?
Good dental benefits alone do not settle the decision. Anyone who is exempted from compulsory insurance during their studies remains privately insured for the entire course of study, because the exemption cannot be revoked. A return to statutory insurance is difficult later, and private premiums can rise. The consumer advice centre compares the options for students.
If you stay in statutory insurance, you can reduce the gap in dentures with supplementary dental insurance. Benefits, waiting periods and limits also differ from tariff to tariff there.
How do you settle dental bills with private health insurance?
Privately insured patients pay the dental bill first and submit it to the insurer. Reimbursement depends on the tariff. For larger treatments, it is worth submitting a treatment and cost plan (Heil- und Kostenplan) to the insurer in advance and waiting for its written statement on reimbursement.
You can submit bills within three years from the end of the year in which they were issued. A bill from March 2026 can be submitted until 31.12.2029.
Frequently asked questions
Does the statutory insurer pay for an implant?
An implant generally does not belong to the standard care. However, the GKV grants the fixed subsidy, which is based on the standard care for your findings. You pay the rest of the bill yourself, including in hardship cases, because there only the costs of the standard care are covered. Have the own share shown in advance in the treatment and cost plan.
Are there waiting periods for dental benefits in private health insurance?
The tariff decides. Some insurers provide waiting periods for certain benefits, others do not. A dental scale that caps reimbursement at the start is more common. You will find both in the tariff conditions, usually in the section on dental benefits or in the special conditions.
Does private health insurance cover orthodontics for adults?
Some tariffs reimburse orthodontic treatment for adults, while others exclude it or limit it. If you can foresee needing braces or splints, check this point before signing the contract and state all known treatments truthfully in the application.
Do I have to submit dental bills straight away?
No, the deadline is three years from the end of the billing year. Still, submit promptly so that any queries can be resolved while the documents are at hand. Keep the bill, the treatment and cost plan and the reimbursement statement together.
So what should you do now?
- Read the sections on dental treatment, dentures and preventive care in the tariff conditions.
- Note the reimbursement rate, maximum amounts, dental scale and waiting periods, and compare them with what you may need in the coming years.
- Before major treatment, obtain a treatment and cost plan and clarify the reimbursement in writing.
- If you want to talk through your situation, you will find the way to a consultation on the Academycon homepage.
You can find experiences with us on ProvenExpert, Trustlocal and Trustindex. Academycon was also mentioned in a press release by Münchner Merkur. An overview of all mentions is on the press page (in German).
Related articles
- Costs at the dentist as a privately insured patient (in German)
- Desire for children and private health insurance (in German)
- The premiums of private health insurance (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
