In short: The reimbursement percentage is the most advertised and least decisive figure. What matters more: the staged annual caps of the first years, whether waiting periods apply, whether the percentage applies to your actual invoice or only to the statutory standard, whether implants are capped by number, and how already-recommended treatment is handled. If you already have a treatment ahead of you, you will generally receive nothing for it.
A supplementary policy can substantially reduce your share of a large restoration. It can also cost years of premiums and pay almost nothing at the decisive moment. The difference is not in the advertised percentage but in the small print.
The most important principle
Insurance covers the unforeseen. If a treatment has already been recommended, diagnosed or recorded in your findings, it is as a rule no longer insurable — even if it has not started. Anyone holding a treatment and cost plan who takes out a policy now will receive nothing for that treatment. The right time to take one out is when you do not need it.
The clauses that make the difference
- Staged caps in the early years: almost all policies limit reimbursement in the first three to five years to graduated maximum amounts. For a large restoration this limit matters more than the percentage.
- Waiting period: some policies only pay after several months. Policies without a waiting period are common but not automatic.
- Basis of the percentage: a policy can reimburse "up to 90 per cent" while taking the statutory standard care as its basis. Check whether the percentage applies to your actual invoice, including material and laboratory costs.
- Offsetting the statutory subsidy: is the fixed subsidy deducted from the reimbursement, or does the reimbursement come on top? A considerable difference to the final figure.
- Implant clauses: many policies cap the number of implants reimbursed per jaw or per period. For All-on-X restorations that is decisive.
- Bone grafting, root canals, prophylaxis: inclusion varies widely. Bone grafting is often excluded, although it is regularly needed with implants.
What to do if you already have a policy
Submit the treatment and cost plan to the insurer before treatment begins and get the reimbursement confirmed in writing. Many policies require prior submission, and submitting afterwards can cost you the benefit. We compile the necessary documents for that — plan, findings and, where required, a justification of the planned restoration.
A realistic view
For young people with healthy teeth a supplementary policy is usually cheap and sensible, because waiting periods and staged caps have expired before any need arises. Anyone already extensively restored often finds only policies with high premiums or exclusions; there the sober calculation is whether saving the money is the clearer solution.
We do not sell insurance and do not recommend providers. What we do: tell you which services are likely to arise in your case, so you can measure a policy against that.
Frequently asked questions
Is a supplementary policy still worth it at 50?
It can be, if the teeth are essentially healthy. The decisive factors are the staged caps of the early years and whether findings are already recorded.
Does supplementary insurance cover professional cleaning?
Many policies reimburse it fully or partly, often with an annual maximum. That is a good comparison point because it is used regularly.
What counts as already recommended?
Anything noted in your treatment records as requiring treatment — including verbal recommendations that appear in the findings. Your answers on the application should match that.
Can I upgrade the policy later?
A move to a higher tier is usually treated as a new policy, with a fresh health assessment and fresh staged caps. That argues for choosing adequate cover from the start.
This article provides general information and does not replace a dental examination. Medically reviewed by Dr. F. J. Rodríguez Ruíz, MSc., dentist at A+ Dental, Düsseldorf-Oberkassel.