What happens when the annual supplementary health insurance budget is used up?

The annual budget for a supplementary dental insurance plan is a key component of the coverage structure—and there are clear rules governing how it is used. It is not uncommon for employees to use up their budget early in the year, especially after major dental procedures or new eyeglasses.

What happens after the budget is exhausted?

Once the annual budget has been exhausted, the insurer will not reimburse any further expenses for the current calendar year—regardless of how necessary the treatment might be. Employees must cover the costs themselves for the remainder of the year or postpone treatment until the following year.

Budget reset at the start of the year

On January 1 of the following year, the budget automatically resets—the full annual amount becomes available again. No activation or re-registration is required. Important: Invoices with a treatment date in the previous year must generally be submitted in the previous year as well; otherwise, they will be allocated to the new annual budget.

Carryover of unused funds

A small number of plans allow unused budget balances to be carried over to the following year—typically capped at a certain amount, such as 50 percent of the annual budget. This is the exception rather than the rule. Under most standard plans, unused portions expire at the end of the year.

Strategic Use of the Budget

For employees facing major upcoming treatments, strategic planning is worthwhile:

  • Spread treatments over two years: first phase in December, second in January — two annual budgets can be used
  • Schedule routine preventive care for the first half of the year: dental cleaning and a checkup in Q1, to ensure the budget is used evenly
  • Communicating additional needs: For foreseeable expensive treatments, such as implants, it’s worth contacting your insurer in advance

Family members

In plans with separate family budgets, each person has their own budget—if an employee’s budget is exhausted, it does not affect their partner’s budget. In plans with a shared family budget, the total amount applies to everyone at the same time, which means it may be used up sooner if there are multiple family members.

What to do if you need more

If your coverage regularly falls short, this is a signal to your employer: consider upgrading your plan, negotiating a higher annual budget, or adding additional coverage options. If you consistently find yourself needing more coverage, you may also want to consider private supplemental insurance to fill specific gaps.

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Related terms

How much does supplemental health insurance cost per employee?
Supplementary health insurance plans typically cost between 10 and 50 euros per month per employee. Plans costing less than 50 euros are tax-free (non-cash benefit limit); higher-cost plans are subject to a flat-rate tax of 30 percent. Premium plans with additional coverage options cost between 60 and 100 euros per month.
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What does the bKV cover for dental prosthetics?
Supplementary health insurance typically covers the full cost of dental prosthetics—crowns, bridges, implants, and dentures—either as part of the annual health budget or through a separate dental coverage option. Standard annual budgets range from 300 to 1,200 euros. Some plans have tiered coverage limits during the first few years of the policy or short waiting periods for major dental treatments.
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How do employees submit invoices to bKV?
Employees submit claims directly to the insurer—typically via an app, web portal, or mail. With app-based insurers, reimbursement takes 5 to 10 business days; with traditional paper submissions, it takes 2 to 4 weeks. The employer is not involved in the process and receives no information about individual claims.
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