General anesthesia at the dentist When does the health insurance company pay??
Local anesthesia is the method of choice for most dental treatments. It is usually sufficient to make the procedure painless and is always covered by the health insurance.
In the case of major interventions, treatment under general anesthesia is also possible – either at the patient’s request or on the advice of the dentist. But here the question arises who has to bear the costs of such general anesthesia.
The statutory health insurance fund only pays the costs of general anesthesia if it is considered necessary from a purely medical point of view. This is primarily the decision of the treating dentist. In order to finally assess the medical need, the health insurance company usually receives advice from specialists from the Medical Service of the Health Insurance (MDK), taking into account the medical report.
Criteria for assuming the general anesthetic costs at the dentist
In the following cases, the statutory health insurance company pays the general anesthetic costs at the dentist:
- in patients with dentist phobia recognized by a doctor or demonstrably treated with psychotherapy,
- in the case of a particularly large surgical intervention in which a simpler form of pain elimination is not sufficient,
- in patients who cannot tolerate a local anesthetic due to an allergy or illness,
- in children under 12 who are difficult to calm down,
- in patients with intellectual disabilities or severe movement disorders.
If the prerequisites for taking over the general anesthetic costs at the dentist are met, the anesthetic services can be billed via the relevant association of statutory health insurance physicians and thus via the health insurance card.
In any case, you should check with your health insurance provider before treatment and, if necessary, have the general anesthetic confirmed with a corresponding cost commitment.
On the other hand, services that are desirable or pleasant for the patient, but are not necessary from a medical point of view, may not be covered by the health insurance companies. A typical example of such a “desired anesthetic” is the removal of all four wisdom teeth: from a medical point of view, the intervention can be carried out in several sessions, each with local anesthesia; however, it would be more convenient for many patients to have all four teeth removed under general anesthesia. In this case, the health insurance will not cover the costs.
Of course, patients have the option of paying the general anesthetic costs out of their own pocket at the dentist. The price of anesthesia usually depends on the duration of the treatment. An average hourly dental treatment costs around 250-300 euros.
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