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Why statutory dental insurance in Germany isn’t always enough
- Statutory dental insurance (GKV) only covers medically necessary, basic treatments using the most cost-effective materials.
- GKV reimbursement for many treatments, especially dentures, is limited to a fixed subsidy of 60% up to 75% of standard costs, depending on bonus status.
- Preventive care for adults and professional teeth cleanings are only partially covered, if at all.
- Supplementary dental insurance can increase reimbursement up to 100%, depending on the chosen plan. It includes higher-quality materials and cosmetic options.
- Additional dental insurance significantly improves access to modern-standard dental treatments and reduces personal expenses for expats, families, and anyone with frequent dental needs.
- The monthly costs for supplementary dental insurance start at €10, depending on the provider and tariff.
Health Insurance in Germany — based on a Dual Structure
The German healthcare system is based on a dual structure separating statutory and private health insurance, which also applies to dental care.
Understanding the different systems, who qualifies for which, and where the limits are, is essential to avoid unnecessary dental costs or limited treatment options.
Who qualifies for which system?
Germany has two main types of health insurance: statutory health insurance (GKV) and private health insurance (PKV).
Around 88% of German residents are covered by public health insurance. It is mandatory for most employees — they can take out private health insurance only with an annual gross income of €73,800 or more. A public health insurance provider also covers most students under 30, pensioners, and recipients of unemployment benefits.
The following individuals are eligible for PKV and can choose between statutory or private health insurance:
- Employees with an income above the insurance obligation threshold of €73,800
- Civil servants
- Freelancers and self-employed individuals
- Students who opt out of GKV at the beginning of their studies or switch after the age of 30
Benefits of public and private health insurance in Germany
Statutory health insurance (GKV) provides a legally defined standard set of dental insurance benefits that applies uniformly to all insured individuals, regardless of their income, insurance contributions, or public insurance provider.
Which treatments, materials, and procedures are medically necessary and reimbursable by public health insurance funds is centrally defined. This ensures equal access to healthcare but means that cost-effective standard treatments are prioritized.
In contrast, the private health insurance system offers contract-based coverage. Policyholders select their benefits according to their health care needs based on the chosen tariff, and insurers calculate monthly premiums based on risk factors like age, health status, and selected services. This allows for individual customization, including premium-level dental treatments, but also requires careful reading of contract terms and exclusions.
Dental care is part of both systems. However, public health insurance covers only basic dental treatment.
While private comprehensive health insurance offers dental coverage based on individual contracts, those insured through GKV require supplementary dental insurance (Zahnzusatzversicherung) if they want to improve their dental benefits. The combination of statutory health insurance and private supplementary insurance provides extensive coverage for your dental health.
The monthly costs for supplementary dental insurance depend on several factors. On average, they range between €10 and €30. The most important factor in the price is the coverage provided by the plan. For a basic plan with partial coverage, you pay lower premiums. When you take out the policy, your age and dental health can also affect the premium amount.
Expats are subject to the same health insurance requirements as German citizens. Health insurance is mandatory from the first day of their residence. Travelers from countries with visa obligations need travel health insurance to obtain a visa. For longer stays (typically starting with 3 months), expats must either join a statutory health insurance company or, if eligible, take out private insurance. Those insured under the GKV system can take out supplementary dental insurance to access higher-quality treatments and reduce personal expenses.
What does statutory dental insurance (GKV) cover?
Statutory health insurance in Germany follows clear legal guidelines. Dental treatments have to be medically necessary, sufficient, and cost-effective. While this ensures a baseline of care for all statutory insured individuals, it also means that higher-quality materials and modern methods are often excluded from coverage or only partially reimbursed.
Basic principle: medically necessary, economical, sufficient
All GKV-insured patients receive the same dental benefits. These are necessary dental care services — additional services must be paid for out of pocket or covered by private supplementary dental insurance.
Treatments are only covered if they are:
- Medically necessary: needed to maintain or restore oral function
- Sufficient: no more than required for adequate care
- Economic: the lowest-cost option that fulfills the medical need
This excludes most aesthetic and premium-quality services by default.
Covered treatments (check-ups, basic fillings, metal dentures)
Public health insurance covers a defined range of basic dental services, including:
- 2 dental check-ups per year for adults
- Professional teeth cleaning once a year, if medically justified as part of periodontal treatments
- Simple fillings (composite is standard for front teeth and usually used for molars as well; however, reimbursement for molar fillings is still based on the cost of amalgam, even though it is rarely used in practice)
- Standard metal-based crowns, bridges, and dentures
- Basic root canal treatment under strict criteria (affected tooth must be classified as “worth preserving”)
- Orthodontics for children and adolescents with severe misalignments (KIG 3–5)
Whether orthodontic treatment for children and adolescents is covered by statutory health insurance depends on the KIG system (KIG = Kieferorthopädische Indikationsgruppen, orthodontic indication groups). Only treatment for severe misalignments (KIG 3-5) is covered. Mild jaw misalignments (KIG 1-2) are considered aesthetic issues, and treatment is not reimbursed. Orthodontic treatment for adults is only provided by the statutory health system in exceptional cases, for example, after accidents or serious illnesses.
What statutory health insurance does not cover
Not covered by public health insurance in Germany are the following dental services:
- Ceramic inlays and crowns
- Implants (except in rare medically necessary cases)
- Purely preventive professional dental cleanings
- Lingual and ceramic braces, Invisalign, and cosmetic orthodontics
- Tooth whitening/bleaching and other aesthetic treatments
- Upgraded materials (e.g., gold crowns, ceramic bridges)
What does supplementary dental insurance add?
Supplementary dental insurance coverage helps GKV-insured patients close financial gaps and access modern treatment options that the statutory health insurance does not reimburse.
Higher reimbursement rates (up to 100%)
Depending on the selected plan, supplementary dental insurance covers 60% to 100% of treatment costs, including standard and premium treatments. This significantly reduces personal expenses for fillings, crowns, dentures, or implants.
Better materials
Private insurance plans cover modern dental materials that are both more durable and aesthetically pleasing:
- Ceramic crowns and inlays
- Gold restorations
- Dental implants and abutments
- High-end bridges
- High-quality dental prosthetics
Cosmetic treatments and preventive extras
Especially premium tariffs may reimburse services GKV does not cover, such as:
- Tooth whitening (bleaching)
- Preventive professional cleanings (1–2×/year or more)
- Early diagnostics and fluoride treatments for adults
- Veneers and aesthetic upgrades
- In-depth functional diagnostics
Orthodontics for adults and non-medical cases in children
Unlike GKV, supplementary insurance may also cover:
- Orthodontic treatment for adults (e.g., Invisalign)
- Cosmetic orthodontics for children with mild misalignments (KIG 1–2)
- Faster access to treatment and broader method choices
Public Health Insurance versus Supplementary Dental Insurance
The following table directly compares the benefits of statutory and private supplementary dental insurance for dental health.
| Treatment | Public Health Insurance | Supplementary Insurance |
|---|---|---|
| Check-ups / Tartar removal | Covered (basic level) | Covered + additional benefits (fluoride, early diagnostics) |
| Professional cleaning | Not covered (unless medically required) | 1–2×/year, often fully reimbursed |
| Fillings | Composite (front). In practice, this also applies to molars, but only the costs for amalgam are reimbursed. |
Composite, ceramic, and other premium materials |
| Crowns & Bridges | Basic metal-only | Ceramic, gold, and other high-quality options |
| Implants | Not covered | Often covered 60–100%, depending on the plan |
| Orthodontics (children) | Only KIG 3–5 (severe cases) | Also, KIG 1–2 and cosmetic orthodontics |
| Orthodontics (adults) | Only in extreme medical cases | Often covered (especially with premium plans) |
| Cosmetic procedures | Not covered | Sometimes included (e.g., whitening, veneers) |
Reimbursement Gaps — What do you pay yourself?
Dental treatment costs in Germany can be substantial, especially when modern materials or aesthetic procedures are involved. Whether and how much you pay depends heavily on whether you have statutory insurance alone or an additional supplementary plan.
Public health insurance: Fixed subsidies for dental treatment
Statutory health insurance does not reimburse dental treatment in full. Instead, it pays a fixed subsidy based on the cost of the standard treatment option — regardless of the actual treatment. This means:
- 60% reimbursement for standard dentures
- With a valid Bonus Booklet: 70% after 5 years, 75% after 10 years (with consecutive annual checks)
- All upgrades (e.g., ceramic crowns) must be paid out of pocket
Full coverage of the costs for standard treatment is only possible in cases of hardship for patients who fall below certain income thresholds and must be approved in advance by the public health insurance company.
Supplementary plans close financial gaps
A good supplementary dental insurance plan significantly reduces the patient’s financial burden:
- Many tariffs cover 80% to 100% of the actual treatment cost.
- Higher coverage usually comes with higher premiums but can pay off quickly.
- Reimbursement is based on the actual invoice, not the GKV subsidy
This makes treatments like implants, ceramic bridges, or professional cleanings much more affordable.
Example comparison: Metal crown vs. ceramic crown
| Treatment | GKV Only | With Supplementary Insurance (90% Coverage) |
|---|---|---|
| Metal crown (standard) | Fully covered (with bonus) | Not relevant (premium option preferred) |
| Ceramic crown (€1,200) | €500 GKV subsidy (equivalent of a metal crown) | €1,080 reimbursed → only €120 paid |
| Without supplementary | You pay €700 out of pocket | — |
How much do you pay with and without supplementary insurance?
| Treatment | Typical Cost | Without Supplementary Insurance | With Supplementary Insurance (80–100%) |
|---|---|---|---|
| Composite filling (molar) | €80–€100 | €30–€50 | €0–€20 |
| Ceramic crown | €1,000–€1,500 | €800–€1,200 | €200–€500 |
| Dental implant | €2,000–€3,000 | €1,500–€2,500 | €300–€600 |
| Ceramic bridge | €1,500–€2,500 | €1,000–€2,000 | €300–€600 |
These numbers clarify that supplementary dental insurance offers valuable financial protection, especially if you need more than basic care.
Who benefits most from supplementary dental insurance?
Not everyone requires the most expensive dental insurance plan, but for many people, supplementary dental coverage in Germany offers real financial advantages and access to higher-quality treatment. Certain groups benefit particularly strongly because of increased dental needs or because statutory insurance doesn’t cover their requirements.
Families with children (orthodontics)
Children often require braces, but statutory health insurance only pays for severe misalignments classified as medically necessary (KIG levels 3–5). Parents must pay out of pocket for milder issues or aesthetic treatments unless they have supplementary insurance, including orthodontics. Many private dental plans offer comprehensive coverage for orthodontics without KIG limitations and for ceramic and lingual braces. Some policies also provide partial reimbursement for Invisalign.
Adults with frequent dental needs (crowns, cleanings)
If you’ve had dental restorations in the past or regularly require crowns, inlays, or professional cleanings, a supplementary plan can quickly pay off. Statutory insurance covers only basic metal crowns and minimal cleaning — better materials and preventive services require co-payments. Supplementary dental insurance helps keep long-term costs under control and supports better dental health and outcomes.
Seniors or those switching from PKV to GKV
Seniors with statutory health insurance schemes and those who return from private to statutory insurance typically experience a significant drop in dental coverage. Supplementary insurance can help close this gap, especially for expensive treatments like implants, crowns, or dental prostheses. Plans without waiting periods are especially helpful here, as dental needs increase with age.
Which limitations remain even with supplementary insurance?
Even the best supplementary dental insurance plans have certain limitations. Be aware of these factors when choosing your coverage:
- Waiting periods: Many plans require you to wait 3 to 12 months before coverage for major dental procedures starts. These periods are longer for costly treatments.
- Annual reimbursement caps: Most policies limit how much they will reimburse annually, especially in the first few contract years.
- Cosmetic exclusions: Basic tariffs usually exclude aesthetic treatments like bleaching.
- Pre-existing conditions: Treatments for already missing teeth or planned procedures when signing the insurance contract are excluded from reimbursement.
Best supplemental dental insurance for expats in Germany
Expats in Germany often face language barriers regarding health insurance and dental treatment. That’s why choosing a provider with expat-friendly features can make all the difference.
Some of Germany’s best dental insurance plans are offered by digital insurance providers such as Ottonova, Feather, and Getsafe. Their services include:
- English-language customer support and contracts
- Digital claim submission and fast processing
- Transparent tariffs with no waiting periods
- Extensive consultation services and user-friendly apps
These insurers offer basic plans for less than €10 per month. Premium plans with comprehensive coverage are only slightly more expensive.
Conclusion: Is Supplementary Dental Insurance Worth It?
Statutory health insurance in Germany offers a solid foundation for basic dental care but leaves significant gaps in high-quality treatments, preventive services, and aesthetics. Supplementary dental insurance helps close these gaps and completes your health insurance — with higher reimbursement rates, better materials, and coverage for treatments that GKV does not support. Without this additional insurance, you must pay for high-quality materials and treatments out of pocket.
A good supplementary plan is almost always worth it for anyone who values modern dental care, financial protection, and flexible treatment access. This is especially true for expats, families, and anyone with frequent or more advanced dental needs.
Our recommendation is to combine public health insurance with a reliable supplementary dental insurance policy from health insurance companies that meet your needs — ideally, one that offers digital claims, no waiting periods, and clear communication in English. This combination provides you with access to comprehensive dental care at predictable costs.
Supplementary dental insurance can make a real difference, especially for anyone seeking modern treatment options without high personal costs.
Frequently Asked Questions — FAQ
No. If you’re fully insured through a private health insurance provider, you typically already have dental coverage in your policy. Supplementary dental insurance is usually unavailable for PKV policyholders, as private health plans already cover preventive care, dental restorations, and even hospital treatment if medically necessary.
Most supplementary dental insurance plans include several months before you can claim reimbursement for major treatments. However, emergency procedures or medically necessary care may still be partially covered. To avoid delays, you can find plans without waiting periods from digital dental insurance providers such as ottonova, Feather, or Getsafe, which are ideal for new residents and expats.
Submitting a claim depends on your insurance provider. With modern digital insurers like ottonova, Feather, or Getsafe, the process is simple: you upload the invoice from your dentist directly to your account via app or online portal. Once reviewed, the reimbursed amount is transferred directly to your bank account. English-speaking service and app support make this especially convenient for Expats.
No, German supplementary dental insurance usually only applies within Germany. If you need dental care abroad — including in your home country — you’ll typically require separate travel health insurance covering emergency medical care and pain relief.
EU citizens can use their European Health Insurance Card (EHIC), issued by their statutory health insurance, to receive urgent treatment across the EU.
Some digital providers, however, go beyond the standard scope:
- Ottonova includes worldwide dental coverage as part of its supplementary plans.
- Getsafe also allows international dental treatment, but requires a treatment plan and prior approval to ensure reimbursement.
A private full health insurance policy generally includes global coverage for dental care, depending on your selected plan.