Dental costs private insurance covers depend on your tariff: the dentist sends you the bill, you pay it and submit it to your insurer. How much you get back depends on the reimbursement rate, the maximum amounts and your deductible. This guide walks you from the bill through the treatment plan to dentures and orthodontics. Where dental benefits fit into the overall picture is shown in our overview of private health insurance benefits for students (in German).
The most important points at a glance
- Privately insured patients pay the dental bill first and submit it to their insurer.
- How much is reimbursed is set out in your tariff: reimbursement rate, maximum amounts and deductible decide.
- For larger treatments, a treatment plan is worth getting before the first appointment.
- Bills can be submitted within three years from the end of the year in which they were issued.
How does the dental bill work in private health insurance?
You receive the bill after the treatment, pay it and submit it to your insurer. There is no direct contractual relationship between the dentist and the insurer, and reimbursement depends solely on your tariff. The principle is described in our guide on cost reimbursement in private health insurance (in German).
You have three years from the end of the year in which the bill was issued to submit it. A bill from March 2026 can therefore be submitted until 31 December 2029. Even so, it is worth sending bills promptly so that you keep track of your costs.
What does a treatment plan contain?
The treatment plan is a written plan from the dentist for a larger treatment such as a crown, bridge or implant. It describes the planned care and the expected costs. You receive it before treatment begins and can discuss it with your insurer before you agree.
Ask before you start which items your tariff reimburses and which it does not. That way you know in advance how high your own share will be. The exact amount is set by the dentist. Dentists bill privately under the scale of fees for dentists (Gebührenordnung für Zahnärzte, GOZ), the amounts vary from practice to practice, and without a plan they cannot be stated reliably.
What do crowns, implants and orthodontics cost?
What a filling, crown, implant or brace costs depends on material, effort and practice. Only your dentist’s treatment plan gives a reliable figure. The logic of reimbursement, however, can be shown with an example.
Example with assumed figures that are not prices for any specific treatment: a dental bill amounts to 1,000 euros. Your tariff reimburses 80 percent and has an annual deductible of 300 euros. If the deductible is deducted first, 700 euros remain. Of this, the insurer reimburses 80 percent, which is 560 euros. Your own share is 440 euros: the 300 euros deductible plus 140 euros for the 20 percent that is not reimbursed. How deductible and reimbursement rate are combined is set by your tariff, so it is worth checking the terms. More on the principle is in our article on deductibles in private health insurance (in German).
| Treatment | What to check in your tariff |
|---|---|
| Dentures (crown, bridge, implant) | Reimbursement rate, maximum amounts, handling of material and laboratory costs |
| Orthodontics | Whether and up to which age it is reimbursed, maximum amounts |
| Wisdom teeth | Whether removal counts as medically necessary treatment, reimbursement rate |
| Professional cleaning and preventive care | Whether prophylaxis is included, annual upper limit |
How dental benefits differ between tariffs is explained in more detail in our article on private health insurance and the dentist (in German).
How much does statutory insurance pay for dentures?
For comparison: statutory health insurance pays a fixed subsidy (Festzuschuss) for dentures. In 2026 it is 60 percent of the standard supply. With a fully documented bonus booklet, it is 70 percent after five years and 75 percent after ten years. For hardship cases, the insurer pays 100 percent of the standard supply.
From 1 January 2027 the fixed subsidy falls from 60 to 50 percent of the standard supply, according to the decided change. Treatment plans approved by 31 December 2026 keep the previous rules. The current amounts are published by the National Association of Statutory Health Insurance Dentists (Kassenzahnärztliche Bundesvereinigung, KZBV).
Dental costs private insurance: what to check in your tariff
- Are there maximum amounts per year or in the first years of the contract?
- What is the reimbursement rate for dentures, orthodontics and prophylaxis?
- Is there a deductible, and how is it applied?
- Which waiting periods or exclusions appear in the terms?
- How is reimbursement handled for pre-existing conditions and treatments already planned?
If you plan larger treatments, include them in your ongoing costs. How to do this is explained in our article on planning health costs during your studies (in German). The contributions themselves are the subject of our article on what private health insurance costs during your studies (in German).
What risks come with private health insurance during your studies?
The exemption from statutory insurance cannot be revoked and normally applies for the entire course of study. Switching back to statutory insurance is normally only possible after you finish your studies. In addition, contributions can rise. In the video, Academycon explains the basics of private health insurance during studies.
Frequently asked questions
Does private health insurance pay the dental bill directly?
Usually not. You pay the bill yourself and submit it to your insurer. Reimbursement depends on your tariff. You have three years from the end of the year in which the bill was issued to do so.
What is the benefit of a treatment plan in private health insurance?
It shows you before a larger treatment which care is planned and what it is expected to cost. With the plan you can ask your insurer which items your tariff reimburses and estimate your own share.
Does private health insurance pay for orthodontics during my studies?
That depends on your tariff. Check whether orthodontics is included, whether there are age limits or maximum amounts, and which reimbursement rate applies. If problems already exist, the health questions in the application may play a role.
Is the removal of wisdom teeth reimbursed by private health insurance?
That is decided by your tariff together with the question of medical necessity. Before the procedure, ask your dentist for a cost plan and ask your insurer what will be reimbursed.
How to proceed now
- Read the dental benefits in your tariff terms and note reimbursement rates and maximum amounts.
- For larger treatments, get a treatment plan from your dentist beforehand.
- Ask your insurer which items are reimbursed.
- Submit bills promptly and set aside money for your own share.
If you want to talk through your situation, you will find the way to advice on the Academycon homepage.
You can read about your experiences with us on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other places, in a report in VersicherungsJournal. An overview of all mentions is on the press page.
Related articles
- Telemedicine in private health insurance: video consultations and costs (in German)
- Cost reimbursement in private health insurance: how the principle works (in German)
- Deductibles in private health insurance explained (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
