Skip to content
Emergency

Dental implant: fixed subsidy and co-payment

Dental implants are comfortable but expensive. The statutory health insurer generally does not regard them as standard care. It usually pays only the fixed subsidy that also applies to the simpler standard solution; you bear the rest yourself.

Reach your next steps and the matching ready-made texts in just a few minutes, free of charge:

Create letter →

Your chances of getting your money back

For dentures there are finding-based fixed subsidies (§ 55 SGB V). Implants usually do not count as standard care; the fund pays the fixed subsidy of the respective standard care, and you bear the extra costs of the implant.
In narrowly limited exceptional cases, a higher subsidy may be considered. A well-kept bonus booklet increases the fixed subsidy; a second opinion helps to compare care and costs.

What you should do now

  1. 1

    1. Treatment and cost plan

    Have a treatment and cost plan drawn up for the planned care.

  2. 2

    2. Clarify the fixed subsidy

    Clarify with the fund the amount of the fixed subsidy for your finding.

  3. 3

    3. Check for exceptions

    Have it checked whether an exceptional case with a higher subsidy applies.

  4. 4

    4. Compare

    Get a second opinion and compare the implant with standard care.

How to spot the scam

  • The high personal costs of the implant are underestimated.
  • The treatment and cost plan is not submitted in advance.
  • Possible exceptional cases are not checked.

Frequently asked questions

Does the health insurer pay for a dental implant?

As a rule, only in the amount of the fixed subsidy for the respective standard care (§ 55 SGB V), because implants usually do not count as standard care. You bear the significantly higher costs of the implant yourself as a co-payment.

Are there exceptions?

In narrowly limited exceptional cases, such as certain severe jaw or facial damage, a higher subsidy may be possible. That is the exception and tied to strict medical conditions. Have it checked in the individual case.

How can I lower costs?

Keep your bonus booklet without gaps; that increases the fixed subsidy. Get several treatment and cost plans and a second opinion, compare the implant with standard care, and check financing or insurance options. Submit the plan to the fund before treatment begins.

Take action now

We put together the ready-made texts and the right places to contact for you.

Create letterCheck a suspicious message
More help: Emergency by phone · Act together · Right to a lawyer · All guides

General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.