Dental cleaning and private health insurance: Optimize costs, maximize benefits
3 Jun 2025
6
Minutes
Katrin Straub
CEO at nextsure
A professional dental cleaning is essential for healthy teeth, but costs can vary. Find out how your private health insurance can optimally support you and which tariffs offer the best benefits.
The topic in brief and concise terms
Private health insurance companies often cover the costs of professional dental cleanings either in full or to a large extent, usually for one to two treatments per year.
The billing for dental cleaning is carried out according to the schedule of fees for dentists (GOZ), where the rate of increase affects the costs; it is advisable to clarify matters in advance with the dentist and the insurance provider.
Choosing the right private health insurance plan is crucial, as the range of services, reimbursement amounts, and frequency of covered dental cleanings can vary significantly.
Quick Facts: Understanding Dental Cleaning and Private Health Insurance Benefits
Professional teeth cleaning (PZR) thoroughly removes bacterial plaque. It effectively prevents cavities and periodontitis. Many private health insurance companies cover the cost. They pay for one or two PZRs per year. The exact coverage depends heavily on the chosen tariff. Public health insurance often pays only a small subsidy. The private health insurance usually offers significantly better conditions here. A PZR typically lasts between forty-five and sixty minutes. This investment in your dental health is worthwhile in the long term. Knowing these basics helps you make the most of your insurance benefits.
Analyse costs and reimbursement of teeth cleaning by private health insurance
The cost of a professional dental cleaning is usually between eighty and one hundred and twenty euros. In major cities or with increased effort, prices can exceed one hundred and fifty euros. Billing is based on the fee schedule for dentists (GOZ). Generally, code one hundred and forty is used. The dentist may adjust the multiplier. The usual rate is two point three times. Many private health insurance tariffs reimburse these costs. It is often up to one hundred percent. You submit the invoice to your insurance company and you will then receive the amount back. Check the exact conditions of your tariff in advance. The reimbursement amount can vary significantly. Secure the best possible cost coverage.
Key factors for cost reimbursement
The reimbursement for dental cleaning depends on several factors. You should be aware of these:
Tariff agreements: The reimbursement amount is defined in the tariff.
Frequency: Many tariffs limit the number of reimbursable cleanings. Often, one to two per year is the limit.
GOZ multiplier: The insurance may only reimburse up to a certain multiplier. Examples include two point three times or three point five times.
Dental tier: In the initial years of insurance, a dental tier may limit the reimbursement amount.
Deductible: An agreed deductible can reduce the reimbursement amount.
Having precise knowledge helps to avoid surprises when billing. Next, we look at frequency and tariff selection.
Ensure optimal frequency and tariff selection for dental cleaning
Dentists generally recommend one to two professional teeth cleanings per year. This frequency helps to maintain optimal oral health. Many private health insurance plans cover these one to two treatments. When choosing your dental insurance plan, pay attention to the mention of professional teeth cleaning. Take note of the reimbursement amount per treatment. Some plans set limits here. A good plan covers at least one hundred euros per professional teeth cleaning. Also compare whether professional teeth cleaning is accounted for in premium refunds. This affects the attractiveness of the plan. Choosing the right plan ensures your long-term satisfaction.
Understanding Legal Frameworks and GOZ Billing
Professional dental cleaning is billed according to the fee schedule for dentists (GOZ). The relevant code is usually GOZ one hundred and forty. This code assesses the service per tooth. It also applies to interdental spaces or implants. The dentist can multiply the basic fee rate. The two point three times rate is common for average effort. For increased effort, billing up to the three point five times rate is possible. However, this requires justification. Transparency is important here: Ask for a cost estimate in advance. The costs of private health insurance can be influenced by such details. The GOZ was last revised in the year two thousand and twelve. An understanding of these basics helps when reviewing your dental bill. This way, you ensure accurate billing.
Expert Tips: Fully Utilize Dental Cleaning and Private Health Insurance Benefits
Optimise the benefits of your private health insurance effectively. Consider a few key points. Confirm with your insurer about cost coverage before undergoing treatment. Always submit invoices completely and promptly. Make full use of the PZR intervals included in your policy, usually once or twice a year. Compare dental supplementary insurances without waiting periods if your private health insurance has gaps. Our expert tip: Carefully document agreements and cost estimates. Some plans even offer higher reimbursements with certain contract dentists. Inquire with your insurer about such networks. Good planning ensures you receive the best services. This underscores the importance of personalised advice.
Important Considerations for Your Decision
When selecting and using your private health insurance for dental cleanings, consider the following points:
Check the exact wording in the insurance policy regarding prophylaxis.
Inform yourself about the maximum number of reimbursable PZR per year.
Clarify up to which GOZ rate the costs will be covered.
Pay attention to any waiting periods or initial benefit limitations (dental scale).
Find out whether PZR costs impact any possible premium refunds.
Compare whether an additional dental insurance might be worthwhile.
These considerations will help you make the most of your private health insurance benefits. The right protection is an important foundation for your health.
The role of dental cleaning in long-term oral health
Professional teeth cleaning is more than just a cosmetic procedure. It removes plaque and tartar in hard-to-reach areas, significantly reducing the risk of cavities and periodontitis. Regular professional cleaning helps to avoid expensive follow-up treatments, such as fillings or dentures. Studies suggest that regular users of professional cleanings require dentures less frequently. Professional teeth cleaning is an investment in the long-term preservation of your teeth. The cost of supplementary dental insurance pays off quickly here. Your private health insurance supports you in this important preventive measure. This way, your smile remains beautiful and healthy.
Differences compared to statutory health insurance (GKV) in dental cleaning
Unlike private health insurance, professional teeth cleaning (PZR) is not a standard service covered by statutory health insurance. Statutory health insurance providers often do not cover the costs or only cover them partially. Contributions often range from twenty-five to seventy euros annually. Some insurers offer PZR through bonus programmes or contracted dentists. Privately insured individuals benefit from more extensive services. Private health insurance usually reimburses PZR costs by eighty to one hundred percent. The frequency of cost coverage is often more generously regulated in private health insurance. This difference makes private health insurance more attractive for dental care. The choice of system directly influences your dental health and your wallet.
Take advantage of personalised advice for optimal protection
More useful links
The Bundeszahnärztekammer offers a comprehensive statement on professional dental cleaning as a prophylaxis for cavities and periodontal diseases.
Statista provides data on consumer price trends for oral care products in Germany.
The IGeL-Monitor of the AOK Federal Association evaluates professional dental cleaning in terms of its benefits.
The Federal Statistical Office (Destatis) offers detailed information on healthcare expenditures in Germany.
On the website of the Federal Statistical Office, you will find tables on the types of services in healthcare expenditures.
The Federal Ministry of Health provides data and facts on health in Germany for the year 2022.
More data and facts on health from the year 2021 are also available on the website of the Federal Ministry of Health.
FAQ
Does my private health insurance cover the full cost of the dental cleaning?
Whether your private health insurance will cover the costs entirely depends on your specific tariff. Many tariffs reimburse one hundred percent, while others stipulate percentage shares or maximum amounts. Checking your contract terms or contacting us will clarify this.
How do I submit the invoice for the dental cleaning to my private health insurance?
You will initially pay the bill yourself at the dentist. Afterwards, you submit the original invoice to your private health insurance for reimbursement, usually by post or digitally via an app.
Should I expect a deductible for teeth cleaning?
That depends on your private health insurance policy. Some policies have a general excess per year or specific excesses for dental services. Please check this in your documents.
What happens if my dentist charges a higher GOZ rate than usual?
A multiplication factor above the 2.3 times rate must be justified in writing by the dentist if billing up to the 3.5 times rate. Please clarify with your insurance in advance up to which rate the costs will be covered. At nextsure, we are happy to advise you on such details.
Can I deduct the cost of the dental cleaning from my taxes?
Expenses for medically necessary treatments that are not reimbursed by insurance may, under certain circumstances, be claimed as extraordinary burdens for tax purposes. This also applies to the <a href="/blog/private-zahnzusatzversicherung-steuerlich-absetzbar">private dental insurance</a>. It's best to discuss this with your tax advisor.
Is a supplementary dental insurance worth it despite good private health insurance benefits for dental cleanings?
This depends on your individual needs and the scope of your private health insurance coverage. A <a href="/solutions/subsolutions/zahnzusatzversicherung">dental supplementary insurance</a> can be beneficial if your private health insurance has gaps, for example, in dental prosthetics or orthodontics (<a href="/blog/kinder-zahnspange-versicherung">children's braces insurance</a>), or if you have specific requirements that go beyond professional teeth cleaning.
