Dental services in private health insurance

Regular check-ups are essential for long-lasting healthy teeth. In the past three years, however, around 15% of the German population avoided visiting the dentist for financial reasons, since without the appropriate insurance, the dentist is often associated with high costs.

Dental forms of treatment such as prophylaxis or professional tooth cleaning to prevent tooth decay and periodontitis are generally not insured by the health insurance companies and must be paid by the patient out of their own pocket. Statutory health insurance (GKV) does not necessarily pay for aesthetically pleasing dentures, so that insured persons have to fall back on inexpensive alternatives wherever possible.

Claim better dental services with the PKV

The benefits of private health insurance (PKV) and statutory health insurance companies vary, particularly in the dental field. In private health insurance, you can determine the type and scope of dental services yourself when you conclude a contract and thus adapt them to your individual needs. A private insurance company usually reimburses 80% for dentures, depending on the tariff, 100% coverage is possible. Private health insurance therefore offers you a high degree of flexibility and benefits.

Do not do without the necessary dentures

The older you get, the more likely you are to be dependent on crowns, bridges and implants. Statutory health insurers only provide regular care for this, which do not completely cover the corresponding costs. In addition, since 2005 the GKV have only provided a findings-based fixed grant of 50% for dentures – regardless of the actual treatment costs.

Regular preventive medical check-ups allow you, as a legally insured person, to secure financial grants, but only up to a total reimbursement limit of 65%. You must pay for any additional services. With private dental insurance, you can also cover most of these additional benefits as a GKV-insured or insured person and thus save enormous costs.

Dental services vary with individual PKV

The reimbursement of costs by private health insurance is regulated differently and depends on the respective tariff. Make sure that the insurance company pays as much of the invoice amount as possible, even if the SHI does not pay.

• With the help of private dental supplement insurance, you can increase the GKV fixed-cost subsidy to a maximum of 100%.
• Alternatively, you can reduce the flat-rate or percentage billing costs with a private health insurance. For example, if your private health insurance covers 90% of the costs, you will be charged an own contribution of 10%.

What is the fixed cost subsidy? There is a fixed standard provision. This is the same for every statutory health insurance. GKV pays your fixed cost subsidy for dentures (at least 50%). If you go to dental check-ups regularly and can check this with your bonus book, the fixed-cost subsidy will be increased to up to 65%.

The reimbursement principles and associated benefits have different effects and vary depending on the tariff and provider. As a rule, the benefits of private insurance companies are limited in the first few years. All dental defects before the contract is concluded are usually excluded from insurance coverage. So take out your supplementary insurance in good time, compare the different tariffs of private providers and get advice from insurance experts. This will make your visit to the dentist a little easier.

All information has been carefully researched and compiled. However, TARIFCHECK24 GmbH assumes no guarantee and liability for the topicality, completeness and correctness of the information provided.

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