Dental Coverage Under Private Health Insurance in Germany
Dental care is one of the areas where the difference between PKV and GKV is most stark and most financially significant. Under GKV, dental benefits are limited — particularly for high-quality prosthetics, implants, and orthodontics. Under PKV, comprehensive dental coverage is a standard feature, and many tariffs cover 70–100% of even the most advanced treatments.
Key difference: GKV provides a fixed subsidy for dental prosthetics based on the cheapest adequate solution. PKV covers a percentage of the actual cost of the treatment you choose — including premium materials and techniques that GKV does not fund at all.
What GKV Covers for Dental Treatment
Under GKV, standard preventive care (routine check-ups, professional cleaning, simple fillings) is covered at normal rates. For dental prosthetics — crowns, dentures, bridges — GKV provides a Festzuschuss (fixed subsidy) of approximately 60% of the standard treatment cost, rising to 70% or 75% for patients who maintain a regular dental check-up record. However, the standard treatment is often the cheapest available material. If you choose ceramic over amalgam, or a precision crown over a standard one, you pay the full difference yourself.
Dental implants are not covered by GKV at all — they are classified as non-standard treatment.
What PKV Covers for Dental Treatment
| Treatment | GKV | PKV (typical) |
|---|---|---|
| Routine check-ups | Covered | Covered (often 100%) |
| Professional cleaning (PZR) | Not covered (or limited) | Covered 1–2x per year |
| Fillings (white composite) | Basic subsidy only for back teeth | Covered at 80–100% |
| Crowns (ceramic) | Basic subsidy only | Covered at 70–100% |
| Dental implants | Not covered | Covered at 50–100% (tariff dependent) |
| Inlays | Not covered | Covered at 70–90% |
| Orthodontics (adults) | Not covered | Covered at 50–80% |
| Orthodontics (children) | Covered for severe cases | Covered at 80–100% |
Annual Dental Spending Caps
Most PKV tariffs include a Summenbegrenzung — an annual or multi-year cap on dental reimbursements in the first few years of the policy. This is designed to prevent people from joining PKV specifically to fund expensive dental treatment immediately. Typical caps are:
- Year 1: €1,000–€2,000
- Year 2: €2,000–€4,000
- Year 3+: Often unlimited or very high cap
If you are planning major dental work, this is an important factor to check in your specific tariff. Work initiated during the dental waiting period (typically 8 months) will also not be covered.
Professional Cleaning (Professionelle Zahnreinigung — PZR)
Professional dental cleaning is widely recommended every 6–12 months but is not covered by GKV. Most PKV tariffs cover 1–2 PZR sessions per year at full cost (typically €80–€120 each). Over a year, this alone represents €160–€240 in direct savings compared to GKV.
Choosing the Right Dental Tariff
Not all PKV tariffs offer the same level of dental coverage. Key things to check when comparing tariffs:
- Does it cover implants? At what percentage?
- What are the annual spending caps in years 1–3?
- Does it cover adult orthodontics?
- Is professional cleaning (PZR) included?
- What is the waiting period for dental prosthetics?
What PKV Dental Cover Typically Includes
Dental benefits are one of the clearest advantages of private cover. Where statutory insurance pays only a fixed subsidy for basic work, PKV reimburses a percentage of the actual cost across a far wider range of treatment:
| Treatment | Typical PKV reimbursement |
|---|---|
| Check-ups, cleaning, fillings | 80–100% |
| Crowns, bridges, prosthetics | 70–90% |
| Implants | Commonly covered (tariff-dependent) |
| Orthodontics | Covered for children; adults tariff-dependent |
Watch the First-Year Limits
To prevent people signing up only for imminent major work, most tariffs apply a sum limit (Summenbegrenzung) in the first three to four years — for example reimbursing only up to a few thousand euros of dental costs in years one to four combined. There is also an eight-month waiting period for dental treatment, which a clean dental examination can waive. After the initial years the limits fall away and full tariff cover applies.
Already in GKV? If you do not qualify for, or do not want, full PKV, a standalone dental supplement (Zahnzusatzversicherung) bolts comprehensive dental cover onto statutory insurance for a modest monthly premium — a popular middle path.
Official Sources & Further Reading
This guide is based on official German regulatory and government sources. Figures such as the income threshold (JAEG) change annually — always confirm current rules with these bodies or a licensed broker before deciding.
- BaFin — Federal Financial Supervisory Authority, regulator of private health insurers.
- PKV-Verband — Association of German Private Health Insurers (Verband der Privaten Krankenversicherung).
- Bundesgesundheitsministerium (BMG) — Federal Ministry of Health.
- SGB V — German Social Code Book V, the statutory basis for insurance obligation and the JAEG threshold (§6).
- Vermittlerregister — official register to verify any German insurance broker's §34d GewO licence.