What Standard PKV Already Includes
Before considering add-ons, it's worth understanding what a comprehensive PKV tariff already covers as standard. Unlike GKV, a full PKV tariff typically includes:
- Basic dental treatment (fillings, extractions, root canals at GOZ standard rates)
- Glasses and contact lenses (often with a fixed annual benefit, e.g., €150–€300)
- Chief physician treatment in hospital
- Private (single or twin-bed) hospital room
- Specialist consultations without GP referral
Add-ons make sense when you want higher limits on these standard benefits — for example, implant-grade dental prosthetics, premium varifocal lenses, or laser eye surgery coverage that exceeds what your base tariff provides.
Rule of thumb: If your base PKV tariff already has dental coverage at 80–100% of GOZ and a hospital room benefit, standalone dental or hospital supplementary policies may not add value. Run the numbers with a broker before adding premiums.
What standard PKV dental covers: Routine treatments — fillings, extractions, root canals, simple crowns — are reimbursed at GOZ (the dental fee schedule) rates. A standard PKV tariff typically covers 80–100% of GOZ-standard costs.
What dental add-ons add:
- Implants — standard PKV may cover implant crowns but not the titanium implant itself. Add-ons can cover implant placement costs (€800–€2,000 per tooth)
- High-end prosthetics (Zahnersatz) — premium crowns, bridges, and full dentures above GOZ standard rates
- Orthodontics for adults — Invisalign or fixed braces typically excluded from standard PKV; add-ons can cover €1,500–€4,000
- Dental prophylaxis — professional cleaning (Prophylaxe, ~€80–€150 per session) not always covered in base tariffs
Typical cost: €15–€40/month depending on implant and orthodontic limits. Most dental add-ons have a waiting period of 3–8 months before large prosthetic claims are reimbursable.
What standard PKV vision covers: Most tariffs include an annual vision benefit — typically €150–€300 for glasses or contact lenses. For many people, this is sufficient for a mid-range pair of prescription glasses.
What vision add-ons add:
- Higher annual limit — premium varifocal lenses can cost €400–€800 for the lenses alone; add-ons raise the benefit to €400–€600
- Laser eye surgery (LASIK/LASEK/SMILE) — costs €1,500–€3,000 per eye; usually excluded from standard tariffs. Dedicated add-ons or premium base tariffs can cover up to €2,000 total
- Sports glasses and goggles — reimbursable under some add-ons
Typical cost: €5–€15/month. If you wear glasses and update them every 2 years, the maths usually favours a small vision add-on.
Standard PKV already includes chief physician treatment and private room benefits that GKV does not offer. So why consider a hospital add-on?
Hospital add-ons are most relevant for:
- GKV members who cannot switch to PKV — GKV patients can add a private hospital supplement that gives them PKV-equivalent hospital access
- PKV tariffs with base-level hospital coverage — cheaper "entry" PKV tariffs sometimes exclude chief physician treatment or limit private room to twin-bed; an add-on restores these
- Complementary and alternative medicine — homeopathy, naturopathy, and osteopathy are not standard PKV coverage but can be added under some tariffs (most practitioners accept PKV patients)
- Extended rehabilitation — post-operative rehab and spa cures (Kur) have session limits in standard tariffs; add-ons extend these
Typical cost for GKV holders: €25–€80/month. For PKV holders upgrading a budget tariff: €10–€30/month.
GKV Holders: Add-On Supplements Worth Considering
If you are in GKV and not yet eligible for PKV, supplementary policies (Zusatzversicherungen) allow you to access private-level care in specific areas without switching to full PKV:
| Add-On Type | What It Gives GKV Members | Monthly Cost |
|---|---|---|
| Dental Zusatz (GKV top-up) | 80–100% dental prosthetics, implants, orthodontics | €8–€35 |
| Hospital Zusatz (GKV top-up) | Chief physician, private room, free choice of hospital | €25–€80 |
| Vision Zusatz | Higher glasses/contact lens benefit, laser eye surgery | €5–€15 |
| Outpatient Zusatz | Alternative medicine, specialist access without referral | €10–€25 |
| Sick Pay (Krankentagegeld) | Income replacement from day 1 of illness (important for freelancers) | €20–€80 |
Is the Add-On Worth the Premium? A Framework
Before buying any supplementary policy, answer three questions:
- What does my current tariff already cover? Read your tariff's Leistungsübersicht carefully or ask your broker. Don't pay for double coverage.
- How likely am I to use this benefit? Dental implants and orthodontics have high per-incident costs; an add-on for these has strong expected value. Laser eye surgery is a one-time event — a dedicated premium may not recover its cost over years.
- What is the waiting period? Most supplementary dental and orthodontic add-ons impose 3–8 month waiting periods. If you have a pending treatment, an add-on won't help you now.
Compare PKV Tariffs for Your Situation
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