This week the CDU Economic Council published a list of proposals intended to strengthen the German economy and the labour market. One of these proposals in particular was met with a significant amount of backlash: That statutory health insurance should stop covering dental treatment altogether, leaving patients to pay out of pocket or rely on private policies.
As of Monday, the German government had already rejected the proposal. Deputy government spokesman Steffen Meyer said clearly, "There are no such plans in the federal government."
But even under current policy, trips to the dentist can be quite costly in Germany, as not all services and treatments are fully covered by public health insurance.
So what aspects of dental care does public health insurance cover, and what is left out?
Basic care (or the cheapest functional option)
Put simply statutory health insurance in Germany gives you a reliable foundation of dental care, but tends to be limited to the cheapest functional option.
So your public health insurance does cover the dental treatments that are considered necessary for the prevention, early detection and treatment of diseases of the teeth, mouth and jaws.
But if you prefer more aesthetic or technically advanced solutions, you'll need to pay the difference – either out of pocket or via additional coverage from a private insurance provider.
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To give some examples, some basic treatments that are usually covered include routine examinations, basic fillings, root canal treatment where the tooth is deemed “worth preserving” and periodontal treatment for gum disease. Also included is the removal of hard dental deposits, commonly known as scaling.
All these treatments are generally covered in full – providing they're medically justified and provided by a dentist who is approved for statutory care.
Check-ups and fillings
Adults are entitled to a dental check‑up every six months. When necessary, the removal of hard plaque may be included.
When it comes to fillings, public health insurance again covers the cheapest functional option, which usually means an amalgam filling for back teeth or a simple composite filling for front teeth.
If you decide to opt for a high‑quality composite filling instead of the standard amalgam filling, you must cover the full cost – not just the additional cost – because it counts as a private service.
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Children and adolescents
Children and adolescents receive particularly comprehensive preventative support in the German healthcare system. From infancy through adolescence, they’re entitled to regular check‑ups designed to make sure their teeth are developing well and to promote good hygiene habits.
Fluoride applications, advice for parents and the sealing of molars are all part of this preventive package.
From the age of twelve, these examinations are recorded in a bonus booklet – which will become important later, if and when dental prostheses are needed.
Braces
When it comes to braces and orthodontic treatment, statutory health insurance in Germany is designed to cover only those cases that are medically necessary, rather than cosmetic.
Braces for children and teenagers are covered in some cases, but coverage of orthodontic treatment for adults over the age of 18 is strictly limited to cases in which surgery is required due to severe jaw abnormalities.
For those under 18, whether or not braces are covered is determined by a grading system known as the Orthodontic Indication Groups (KIG), which ranks the severity of a child’s dental misalignment from level 1 (very mild and considered cosmetic) to level 5 (extreme and medically urgent). Public insurance only covers treatment for cases assessed at KIG level 3, 4 or 5.
When braces are covered, the insurer initially pays 80 percent of the approved treatment costs while parents or guardians pay the remaining 20 percent; this contribution is then reimbursed at the end of the treatment, provided it is completed successfully.
Even in approved cases, statutory insurance does not pay for aesthetic or comfort upgrades such as tooth‑coloured brackets, braces that sit behind the teeth, or high‑tech wires.
With the average course of orthodontic care ranging between €2,600 and €9,000, parents should be prepared for significant additional costs if they choose more discreet or technologically advanced options beyond the standard metal braces covered by public insurance.
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Crowns, bridges and dentures
The picture becomes more complex when it comes to dental prostheses such as crowns, bridges and dentures.
Here the statutory system works differently because it never covers the full cost. Instead, patients receive a fixed subsidy determined by the diagnosis and based on the standard treatment for that condition.
The basic subsidy covers 60 percent of the cost of this standard treatment.
And here’s where the bonus booklet comes in handy: If you can demonstrate that you attended regular annual check‑ups for the previous five years, this subsidy rises to 70 percent. With ten years of uninterrupted entries in your bonus booklet, it reaches 75 percent.
But even then, statutory health insurance only ever pays based on the cost of the standard option.
So if a simple metal bridge costs €800, then the standard subsidy would be €460. Should you decide to have a ceramic bridge costing €1,500, you'll still only see €460 covered by your insurance.
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