Reimbursement of costs in statutory health insurance

The statutory health insurance cannot cover all the services that modern dentistry offers you. But you have the opportunity to enjoy more freedom in the choice of therapy: With the reimbursement of costs, you can use the latest diagnostic and treatment options without losing the subsidy from the health insurance company to which you are entitled for the statutory benefit. This can be useful, for example, in periodontitis therapy, root canal treatment or orthodontic treatment of your children.

How does reimbursement work?

If you choose reimbursement, you no longer need to present your health insurance card or health card in practice. You will receive an invoice according to the private fee schedule for dentists (GOZ). You submit the invoice to your cash register, from which you will receive a refund.

What do you need to consider?

Some health insurance companies also make a cost contribution for certain therapies, such as the supply of dental prostheses, dependent on an approval procedure before the start of treatment. The following applies to all health insurance companies: If the treatment chosen goes beyond the benefits of the health insurance company, additional costs will be incurred, which you will have to bear yourself, unless you have supplementary insurance that participates in it. The fund reimburses only the costs that would have been incurred if the insurance card had been billed. In addition, it can deduct administrative costs of a maximum of five percent from the reimbursement amount. You can choose reimbursement for yourself and/or co-insured family members and limit it to dental care. The decision shall be valid for at least three months. The dental profession is committed to making the procedure even more patient-friendly in the future.

How do you choose reimbursement?

Before you make use of services, inform the health insurance company of your decision to reimburse the costs. Your dentist will tell you the details. Some health insurance companies also offer special reimbursement rates for which you must conclude a contract.

Further information on the topic of reimbursement in statutory health insurance
pdf
kostenerstattung pdf kostenerstattung tr pdf kostenerstattung r pdf