What does the bKV cover for dental prosthetics?

Dental prosthetics are one of the most costly areas covered by supplemental health insurance. Statutory health insurance only covers a fixed subsidy of 60 to 75 percent of standard treatment—any costs beyond that are paid by the patient. Supplemental health insurance fills exactly this gap.

What is considered a dental prosthesis

  • Crowns, bridges, and inlays
  • Implants, including subsequent restoration
  • Partial and full dentures
  • Root canal and periodontal treatments (often covered under the same category)

Reimbursement models in supplementary health insurance plans

Budget plans: Dental prosthetics are covered by the annual health budget, often without a specific cap. A €900 budget can be used in its entirety for implant treatment.

Modular plans with a dental module: A separate coverage category with its own budget or percentage reimbursement (typically 80 percent of the remaining costs after statutory health insurance coverage). Often on a sliding scale: 50 percent in the first year, 70 percent in the second, and 90 percent starting in the third year of the contract.

Premium plans: Full reimbursement with no annual cap, though there may be an overall limit for the first 24 months (approximately 3,000 euros).

Special Case Regarding Waiting Period

While most modern supplementary health insurance plans have no waiting periods at all, dental prosthetics are the most common exception. To prevent adverse selection, some plans maintain an 8-month waiting period for more expensive dental treatments costing over 500 euros—or cap coverage during the first few years of the policy. It’s worth taking a close look at the terms and conditions before signing a plan.

Strategy for Expensive Treatments

For dental implants or major restorations that take 6 to 12 months to complete, it makes sense to spread the treatment phases across two billing years—for example, with the first invoice in December and the second in January. This allows you to utilize two annual budgets.

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Related terms

What is a company health insurance plan (bKV)?
Employer-sponsored health insurance (bKV) is a supplementary insurance plan funded by the employer for employees covered by statutory health insurance. It covers services that statutory health insurance (GKV) does not reimburse, or only reimburses to a limited extent—such as dental prosthetics, eyeglasses, alternative practitioners, or advanced preventive care. Up to 50 euros per month, it is exempt from taxes and social security contributions.
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Which preventive medical exams are covered by the bKV?
Supplementary health insurance (bKV) typically covers advanced preventive care services not included in the statutory health insurance (GKV) catalog—such as annual comprehensive checkups, cancer screening for those under the GKV age limits, HPV tests, services not covered by statutory health insurance (IGeL), travel vaccinations, and modern imaging procedures. A list of eligible services can be found in the respective plan terms and conditions.
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Can family members be covered under the supplementary health insurance plan?
Yes, most supplemental health insurance plans offer a family option that covers spouses, domestic partners, and children. During the enrollment window (typically 3 to 12 months after the policy begins), coverage can be added without a medical exam. Depending on the plan, premiums for family members are paid by the employer, the employee, or shared between the two.
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