Private dental insurance for statutory health insurance holders: When it really makes sense
03.06.2025
7
Minutes
Katrin Straub
Managing Director at nextsure
A high dental bill can quickly become a financial burden, as statutory health insurance often covers only a fraction of the costs. Private dental insurance for people with statutory insurance can help here. Find out how you can save thousands of euros and receive the best possible treatment.
The topic in brief and concise terms
Statutory health insurance (GKV) covers only around 60 per cent of the costs of standard basic care, which can lead to financing gaps of several thousand euros for high-quality dental prostheses.
Private dental supplementary insurance is particularly worthwhile for people with statutory health insurance who value modern dental restorations such as implants or ceramic crowns and want to avoid high out-of-pocket costs.
When choosing a plan, look for a generous dental benefit scale, no waiting periods and reimbursement of up to 3.5 times the schedule of fees for dentists (GOZ).
The GKV benefit limits: What the insurer really pays
Statutory health insurance (GKV) only covers the cost of dental treatments up to a fixed limit. It pays a fixed subsidy based on the findings, amounting to around 60 per cent of the cost of standard treatment, the so-called standard care. This standard care is defined as “adequate, appropriate and economical” and often represents only basic coverage.
For example: for a crown in the non-visible posterior area, the standard care is a full cast metal crown. If you want a tooth-coloured ceramic crown, you must pay the additional costs of several hundred euros yourself. Professional teeth cleaning, which dentists recommend at least once a year, is also not part of standard care and is only subsidised by a few health insurers. The GKV fixed subsidy therefore never covers the cost of modern or aesthetically demanding treatment.
Regular preventive check-ups, which are documented in your bonus booklet, can increase the subsidy to 70 per cent after five years and to 75 per cent of the standard care costs after ten years. Despite this bonus, there remains a significant funding gap with high-quality dental prosthetics, which you as the patient must cover. GKV benefits are therefore basic coverage, but not comprehensive insurance for your teeth.
Dental prosthetics cost trap: a practical calculation example
The true costs of the statutory health insurance coverage gap are most evident with expensive dental prosthetics such as an implant. The cost of a single dental implant with crown in Germany quickly ranges between 2,200 and 4,200 euros. However, the statutory health insurer does not contribute to the cost of the implant itself, i.e. the artificial tooth root.
The GKV only pays the fixed subsidy for standard care, which in this case would be a bridge. Depending on your bonus booklet, this subsidy is around 500 to 700 euros. This means you could be left with an out-of-pocket cost of up to 3,500 euros or more for just one tooth. Stiftung Warentest puts the private expense for an implant in the lower jaw at around 3,850 euros. Without a suitable supplementary dental insurance, you must pay this amount in full out of pocket.
The following list illustrates the typical cost breakdown for a dental implant:
Total cost (implant + crown): approx. 3,200 euros
GKV fixed subsidy (for a bridge): approx. -550 euros
Your out-of-pocket share without supplementary dental insurance: approx. 2,650 euros
Your out-of-pocket share with good supplementary dental insurance (90% reimbursement): approx. 320 euros
These figures make it clear that the question is not whether dental treatment will become expensive, but only when. Private cover is therefore a strategic decision for your financial health.
What a good dental insurance policy should cover
A powerful private dental insurance policy for people with statutory health insurance protects you from high out-of-pocket costs and gives you access to high-quality dental treatment. Depending on the level of cover chosen, the plans reimburse between 80 and 100 per cent of the costs for dentures, dental treatment and preventive care. This effectively closes the coverage gap left by statutory health insurance. A good plan should cover a broad range of treatments.
The most important areas of cover include:
Prosthetics: Coverage of the costs for implants, bridges, crowns and dentures well beyond the statutory insurance fixed contribution.
Dental treatment: Cost coverage for high-quality composite fillings, root canal treatment and periodontal therapy.
Preventive care: Reimbursement for professional dental cleanings, often once or twice a year up to an amount of 100 euros or more.
Orthodontics: Contributions towards braces for children and in some cases also for adults.
Make sure the plan also pays when statutory health insurance does not provide any advance payment, as is the case with implants. The best dental supplementary insurance adapts to your individual needs and covers exactly the areas that matter to you. That way, a trip to the dentist does not become a financial pitfall.
Expert tips for choosing a plan: dental limits, waiting periods and GOZ
When choosing the right supplementary dental insurance, the details are crucial. A key point is the so-called “dental benefit scale” or benefit limit in the first few years. Many plans limit reimbursement in the first four to five years of the contract to amounts such as €1,000 in the first year and €2,000 in the first two years. Look for plans with a scale that is as generous or as short as possible.
Some plans advertise that they provide cover immediately with no waiting period. This means that you have insurance cover from day one. However, this usually does not apply to treatment that has already been recommended or started. Our expert tip: take out insurance before the dentist identifies 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 tooth replacement is needed.
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 involved, to up to 3.5 times the standard rate or higher. A good plan should cover at least up to 3.5 times the GOZ rate, to protect you from co-payments even for complex treatments.
Tax deductibility and long-term planning
The contributions for private dental supplementary insurance can be claimed in your tax return. They count as other precautionary expenses and can be deducted within the maximum limits. For employees, the maximum amount is EUR 1,900 per year, for self-employed people EUR 2,800. However, this amount is often already used up by contributions to health and long-term care insurance.
Nevertheless, the tax deductibility is a small financial advantage. Much more important is long-term financial planning. Dental supplementary insurance is an investment in your health and in preserving your assets. Monthly contributions of EUR 20 to 60 are predictable, unlike a sudden dentist's bill of over EUR 3,000.
Bear in mind that most plans do not build up ageing reserves. This means that contributions may increase over time. However, taking out a policy early secures permanently favourable terms and protects you from unpleasant surprises in old age. That way, your smile remains not only healthy, but also affordable.
Request your individual risk analysis now
Statutory health insurance provides only basic cover for your teeth. Private dental insurance for people with statutory insurance is therefore a sensible addition, helping to avoid high costs and secure access to modern dentistry. With the right tariff, you can effectively protect yourself against financial burdens. Have your insurance situation checked free of charge and receive specific suggestions for improvement.
More useful links
The Federal Statistical Office (Destatis) provides statistical data and press releases, which may also include information on dental care and healthcare expenditure.
The Federal Ministry of Health (BMG) provides official information on dental treatment, benefits and guidelines.
The Consumer Advice Centre offers an independent assessment and information on whether taking out supplementary dental insurance is worthwhile.
The GKV-Spitzenverband provides information on dental care and the benefits of statutory health insurers.
The Federal Dental Chamber (BZÄK) provides statistical data and figures on dental care and dentists in Germany.
The German Society for Dental, Oral and Maxillofacial Medicine (DGZMK) provides information on research, teaching and continuing education in the field of dental, oral and maxillofacial medicine.
The Institute of German Dentists (IDZ) is a research institution that deals with various topics relating to dental care.
The Consumer Advice Centre offers a detailed PDF document with analyses and assessments on the subject of supplementary dental insurance.
FAQ
Is private dental insurance worthwhile for people with statutory health insurance?
Yes, it is very worthwhile. The statutory health insurance fund (GKV) only covers a fixed subsidy for standard treatment. For modern treatments such as implants or ceramic crowns, high out-of-pocket costs arise, which supplementary dental insurance can significantly reduce.
What does standard dental care mean?
The standard care is the dental standard treatment, which is classified by the GKV as sufficient and economical. This is often the simplest solution, e.g. a metal crown instead of a ceramic crown. You must pay for any additional requests yourself.
What is the schedule of fees for dentists (GOZ)?
The GOZ is the basis on which dentists bill private services. It enables the dentist to adjust the price depending on the level of difficulty and time required (scaling factor). A good insurance tariff should cover benefits up to at least 3.5 times the GOZ rate.
Can I claim the premiums for dental insurance as a tax deduction?
Yes, the contributions can be entered in the tax return as other deductible precautionary expenses. However, the maximum amount is often already exhausted by contributions to health and long-term care insurance, meaning that in many cases no additional tax saving results.
Is there a waiting period for dental insurance supplements?
Many modern plans dispense with a general waiting period, so you can claim benefits for treatments diagnosed after the contract starts straight away. However, please note the benefit scale, which limits reimbursement in the first few years.
When is the best time to take out dental supplementary insurance?
The best time is while your teeth are still healthy and no treatment is needed. Experts such as Stiftung Warentest recommend taking out a policy in your mid-30s or early 40s, as from this age onwards, statistically speaking, dental prostheses are needed more often.
