Private dental insurance for those with statutory coverage: When it really makes sense
3 Jun 2025
7
Minutes
Katrin Straub
CEO at nextsure
A high dental bill can quickly become a financial burden, as the statutory health insurance often covers only a fraction of the costs. A private dental insurance for those with statutory insurance can help here. Discover how you can save thousands of euros and receive the best possible treatment.
The topic in brief and concise terms
The statutory health insurance (GKV) covers only about 60 percent of the costs for basic standard care, which can lead to financing gaps of several thousand euros for high-quality dental prostheses.
A private dental supplementary insurance is particularly useful for those with statutory insurance who value modern dental prostheses such as implants or ceramic crowns and wish to avoid high out-of-pocket expenses.
When choosing a tariff, look for a generous dental fee schedule, no waiting periods, and reimbursement up to 3.5 times the fee schedule rate for dentists (GOZ).
The statutory health insurance benefit limits: What the fund really pays
The statutory health insurance (GKV) covers dental treatment costs only up to a specified limit. It pays a diagnosis-based fixed subsidy, which is approximately 60 percent of the costs for the standard treatment, known as routine care. This routine care is defined as ‘adequate, appropriate, and economical’ and often only provides basic coverage.
An example: For a crown in the non-visible posterior tooth area, the routine care is a full metal cast crown. If you prefer a tooth-coloured ceramic crown, you have to bear the additional costs of several hundred euros yourself. A professional dental cleaning, which dentists recommend at least once a year, is also not part of routine care and is only subsidised by a few insurers. The GKV's fixed subsidy therefore never covers the costs for modern or aesthetically demanding care.
Through regular check-ups documented in your bonus booklet, the subsidy can increase to 70 percent after five years and to 75 percent after ten years of routine care costs. Despite this bonus, there remains a significant financial gap with high-quality dental prostheses that you, as a patient, must cover. Therefore, the GKV service is a basic safety net, not comprehensive insurance for your teeth.
Cost Trap Dentures: A Practical Example
The true costs of the statutory health insurance coverage gap are most evident in expensive dental prostheses like an implant. The costs for a single dental implant with a crown in Germany quickly range between 2,200 and 4,200 euros. However, the statutory health insurance does not contribute to the costs for the implant itself, meaning the artificial tooth root.
The statutory health insurance only pays the fixed subsidy for standard care, which in this case would be a bridge. This subsidy is approximately between 500 and 700 euros, depending on the bonus booklet. This means for you an out-of-pocket expense of up to 3,500 euros or more for just a single tooth. Stiftung Warentest estimates the private cost for an implant in the lower jaw at around 3,850 euros. Without an appropriate dental supplementary insurance, you must cover this amount entirely from your own pocket.
The following list illustrates the typical cost allocation for a dental implant:
Total costs (implant + crown): approx. 3,200 euros
Statutory health insurance fixed subsidy (for bridge): approx. -550 euros
Your out-of-pocket expense without supplementary dental insurance: approx. 2,650 euros
Your out-of-pocket expense with good supplementary dental insurance (90% reimbursement): approx. 320 euros
These figures clearly show that the question is not whether a dental treatment will be expensive, but only when. Therefore, private coverage is a strategic decision for your financial well-being.
Scope of a good dental supplementary insurance
A robust private dental insurance for statutory health insured persons protects you from high out-of-pocket expenses and grants you access to high-quality dental care. Depending on the chosen coverage, the rates reimburse between 80 and 100 percent of the costs for dental prosthetics, dental treatments, and prophylaxis. This effectively closes the gap left by statutory health insurance. A good plan should cover a wide range of treatments.
Key areas of coverage include:
Dental prosthetics: Coverage of costs for implants, bridges, crowns, and dentures far beyond the statutory health insurance subsidy.
Dental treatment: Coverage for high-quality composite fillings, root canal treatments, and periodontal therapies.
Prophylaxis: Reimbursement for professional dental cleanings, often once or twice a year up to an amount of 100 euros or more.
Orthodontics: Subsidies for braces for children and sometimes also for adults.
Ensure that the plan also provides benefits when the statutory health insurance does not offer preliminary benefits, as is the case with implants. The best dental supplementary insurance adapts to your individual needs and covers exactly the areas that are important to you, ensuring a visit to the dentist doesn't become a financial burden.
Expert tips on choosing a tariff: dental tariffs, waiting periods, and GOZ
When choosing the right supplementary dental insurance, details are crucial. A key point is the so-called 'dental scale' or benefit limitation in the first few years. Many policies limit reimbursement in the first four to five years of the contract to amounts like €1,000 in the first year and €2,000 in the first two years. Look for policies with the most generous or shortest scale possible.
Some policies advertise that they provide immediate coverage without a waiting period. This means that you enjoy coverage from the first day. However, this usually does not apply to treatments that have already been recommended or started. Our expert tip: Take out insurance before the dentist determines a specific need for treatment. Stiftung Warentest recommends taking out a policy in your mid-30s or early 40s, as this is often when the first major dental prosthesis becomes necessary.
Another important aspect is the fee schedule for dentists (GOZ). Dentists bill private services according to this schedule and can increase the billing rate depending on the effort up to 3.5 times or higher. A good policy should cover at least up to the 3.5 times rate of the GOZ to protect you from additional payments even in complex treatments.
Tax deductibility and long-term planning
The contributions for a private supplementary dental insurance can be claimed in your tax return. They count as other precautionary expenses and can be deducted within the limits. For employees, the maximum amount is 1,900 euros per year, for self-employed individuals it is 2,800 euros. However, this amount is often already exhausted by contributions to health and nursing care insurance.
Nevertheless, the tax deductibility is a small financial advantage. Much more important is long-term financial planning. Supplementary dental insurance is an investment in your health and the preservation of your assets. The monthly contributions of 20 to 60 euros are predictable, in contrast to a sudden dental bill of over 3,000 euros.
Be aware that most tariffs do not create age reserves. This means that contributions can increase over time. However, an early conclusion ensures permanently favourable conditions and protects you from unpleasant surprises in old age. This way, your smile remains not only healthy but also affordable.
Request a personalised risk analysis now
The statutory health insurance only offers basic coverage for your teeth. A private dental insurance for those with statutory insurance is therefore a sensible addition to avoid high costs and to secure access to modern dental care. With the right plan, you can effectively protect yourself from financial burdens. Have your insurance situation checked for free and receive specific suggestions for optimisation.
More useful links
The Federal Statistical Office (Destatis) offers statistical data and press releases, which can also include information on dental care and health expenditures.
The Federal Ministry of Health (BMG) provides official information on dental treatment, services, and regulations.
The Consumer Association offers an independent evaluation and information on whether taking out supplementary dental insurance is worthwhile.
The National Association of Statutory Health Insurance Funds provides information on dental care and the services of statutory health insurance funds.
The Federal Dental Association (BZÄK) provides statistical data and figures on dental care and dentists in Germany.
The German Society of Dental, Oral, and Maxillofacial Medicine (DGZMK) provides information on research, teaching, and training in the field of dental, oral, and maxillofacial medicine.
The Institute of German Dentists (IDZ) is a research institution that deals with various topics of dental care.
The Consumer Association offers a detailed PDF document with analyses and evaluations on the topic of supplementary dental insurance.
FAQ
Is a private dental insurance worthwhile for statutory insured individuals?
Yes, it makes a lot of sense. The statutory health insurance (GKV) only covers a fixed subsidy for standard care. For modern treatments such as implants or ceramic crowns, there are high out-of-pocket costs, which can be significantly reduced by taking out supplementary dental insurance.
What does standard care at the dentist mean?
Standard care is the dental treatment classified by the statutory health insurance as adequate and economical. This is often the simplest solution, for example, a metal crown instead of a ceramic crown. Any additional requests must be financed by you.
What is the fee schedule for dentists (GOZ)?
The GOZ is the basis on which dentists bill private services. It allows the dentist to adjust the price according to the difficulty and time required (multiplier). A good insurance plan should cover services at least up to 3.5 times the GOZ rate.
Can I deduct the contributions to the dental insurance from my taxes?
Yes, the contributions can be declared as other pension expenses in the tax return. However, the maximum limit is often already exhausted by contributions to health and long-term care insurance, so in many cases, there is no additional tax saving.
Is there a waiting period for dental supplementary insurance?
Many modern plans do not have a general waiting period, allowing you to immediately access benefits for treatments diagnosed after the start of the contract. However, please note the tiered benefits that limit reimbursement in the initial years.
When is the best time to take out dental supplementary insurance?
The best time is while your teeth are still healthy and there's no need for treatment. Experts like Stiftung Warentest recommend an agreement in your mid-30s or early 40s, as statistically, dental prostheses are needed more frequently from this age onwards.
