Taking out dental supplementary insurance despite ongoing treatment: how to cover costs
18/07/2025
9
Minutes
Katrin Straub
Managing Director at nextsure
Has the dentist recommended an expensive treatment and you don’t have insurance? Most policies now refuse to cover the costs. However, there are special plans that still provide cover even if treatment is already underway.
The topic in brief and concise terms
Taking out dental supplementary insurance is only possible with immediate cover in very few special tariffs, even if treatment is already ongoing.
A treatment is already considered to be “recommended” if there is a note in the patient file – a treatment and cost plan is not necessarily required.
Answering the health questions truthfully is a legal obligation; false statements may result in denial of benefits.
The situation: Why insurers decline ongoing treatment
The core of the problem lies in insurance law: Insurance covers risks, not certainties. As soon as a dentist recommends or begins treatment, this is deemed an insured event to have occurred. For the insurer, the cost risk is therefore 100 per cent certain, which conflicts with the basic principle of the risk community. Treatment is already considered to have been recommended if there is a corresponding note in your patient file, even without a treatment and cost plan. However, check-ups or professional dental cleaning do not fall under this. This distinction is crucial for any later entitlement to benefits. Taking out cover often still makes sense for all future treatments. This protects you against new, unexpected costs, even if the current measure is no longer insured.
Special rates as a solution: insurance cover with immediate benefits
A small number of providers have recognised the market gap and offer dental supplementary insurance with immediate cover. These policies waive the usual waiting periods and, in some cases, even cover treatments that have already been recommended or started. The catch: these policies are often associated with higher premiums or initial limits on benefits. For example, such a tariff may cover the costs of up to three missing teeth, even if a treatment and cost plan has already been drawn up. Check carefully here which treatments are specifically covered and which are not. These specialist tariffs are the only way to find an answer to the question “Can I take out dental supplementary insurance despite ongoing treatment?” that allows costs to be covered. Without this specialisation, retrospective cover is not possible.
Cost-benefit analysis: When it really pays to sign up
Whether such a special plan is worthwhile is shown by a simple calculation. Suppose a dental crown costs 1,300 euros, of which the statutory health insurance fund covers only 450 euros. Your out-of-pocket cost is therefore 850 euros. An immediate plan may cost you 45 euros per month, or 540 euros in the first year. Even with these contributions, you save 310 euros in the first year. The savings often exceed the annual premium with the very first major treatment. Here is an example cost breakdown:
Total treatment costs: 1,300 euros
Health insurance contribution: 450 euros
Remaining out-of-pocket cost: 850 euros
Plan costs per year: 540 euros (12 x 45 euros)
Your savings in the first year: 310 euros
This calculation shows why it is so important to carefully compare the costs of dental supplementary insurance with the benefits you expect to receive. That way, you can make an informed decision.
The hurdle of health questions: honesty is paramount
When applying, you must answer health questions truthfully. This is not a request, but a legal obligation (pre-contractual duty of disclosure under § 19 VVG). If you fail to disclose a treatment that was recommended to you, the insurer may withdraw from the contract or refuse to pay the benefit. Even tariffs advertised as insurance without health questions often exclude already known conditions in the terms and conditions. Forgetting to mention a recommended root canal treatment can jeopardise the entire contract. Insurers scrutinise the information very carefully when a claim is made, often by checking with the treating dentist. Dishonesty here almost always leads to the rejection of cost coverage.
Benefit tiers and sum limits as limiting factors
Almost every policy, especially those with immediate benefits, works with a so-called dental benefit schedule. This limits the maximum reimbursement in the first few years. A typical schedule could look like this:
In the first year of insurance, maximum reimbursement of EUR 1,000.
In the first two years combined, a maximum of EUR 2,000.
In the first three years combined, a maximum of EUR 3,000.
From the fourth year onwards, the limit is often removed.
Choose a policy whose benefit schedule matches your expected treatment needs. An expensive implant treatment costing EUR 4,000 will not be fully covered in the first year, even with a 100% policy, if the schedule caps reimbursement at EUR 1,000. These limits are a key point in explaining when the insurer does not pay, even though the procedure would in principle be covered. A precise understanding of the schedule is therefore essential for planning.
Your strategy for success: Four steps to the right protection
To achieve the best possible protection despite ongoing treatment, a strategic approach is essential. With the right preparation, you can find a suitable supplementary dental insurance that noticeably reduces your costs. Work through the following four steps carefully:
Document status precisely: Clarify with your dentist exactly what is noted in your records. Is it a vague recommendation or a specific treatment and cost plan?
Target your search for immediate-cover tariffs: Focus your search exclusively on insurance policies that explicitly cover recommended or ongoing treatments. Only around five per cent of tariffs offer this.
Compare benefit details: Pay attention not only to the reimbursement rate, but above all to the dental benefit schedule, exclusions and the exact definition of the insured event.
Answer health questions precisely: Take your time and answer every question 100 per cent correctly. If in doubt, it is better to provide too much information rather than too little.
This structured approach minimises the risk of a rejection and maximises your chance of costs being covered. That way, you move from identifying the problem to finding a concrete solution.
Finding the right tariff while treatment is ongoing is complex and prone to errors. An incorrect detail or choosing the wrong product can cost you thousands of euros. Have your insurance situation reviewed free of charge by our experts and receive specific optimisation recommendations tailored to your individual circumstances.
More useful links
The Consumer Advice Centre offers comprehensive information on the risks and benefits of supplementary dental insurance.
Statista provides statistics on spending for dental treatments by type of treatment.
Another statistic from Statista shows spending per insured person treated by a dentist, by federal state.
The annual report of the Federal Dental Association (BZÄK) provides insights into dental care.
The Federal Statistical Office (Destatis) publishes a quality report on the cost structure in the medical sector (2021).
The official website of the Federal Statistical Office (Destatis) provides access to a wide range of official statistics.
The Statistical Yearbook 2024 of the National Association of Statutory Health Insurance Dentists (KZBV) contains current data on dental care.
The Federal Ministry of Health provides information on aspects of dental treatment in Germany.
The portal gesund.bund.de, an initiative of the federal government, provides information on dental services.
FAQ
Can I take out dental supplementary insurance despite ongoing treatment?
As a rule, this is not possible with most insurers. However, there are a few specialist providers whose policies can still be taken out and will pay out even when treatment has already been recommended or is underway. However, these are often more expensive or initially limited in terms of the level of cover.
Does the insurance cover the costs if the treatment and cost plan has already been prepared?
No, if the treatment and cost plan was prepared before the contract was concluded, the treatment is regarded as an insured event that has already occurred. The costs for this are not covered by 99 per cent of all tariffs. Only special "immediate assistance" tariffs may be an exception here.
What happens if I fail to mention an ongoing treatment in the application?
Failing to disclose an ongoing or recommended treatment is a breach of the pre-contractual duty of disclosure. In the event of a claim, the insurer may refuse payment, withdraw from the contract or terminate it. You lose your insurance cover and are left to bear the costs.
Is it still worth taking out a policy if the current treatment isn’t paid for?
Yes, taking out the policy can still be worthwhile. It gives you cover for all future dental treatments that are not yet known today. The premiums are often lower than with special tariffs, and you avoid facing the same problem at your next treatment.
Are there tariffs that cover ongoing orthodontic treatment?
No, ongoing orthodontic treatment is excluded from cover under all the tariffs we are aware of. In this case, taking out cover only makes sense for future, new treatments, not to cover measures already in progress.
Do plans without health questions cover ongoing treatments?
Not necessarily. Even plans without health questions often exclude benefits for treatments that were recommended or started before the contract began in their terms and conditions. Omitting the questions merely simplifies the application process.
