If dental treatment has already been recommended

You can usually still take out a policy, but a standard plan will not pay for that treatment: anything the dentist recommended or started before you signed is excluded. What the dentist finds later is paid under the plan’s terms. For treatment already recommended there is the ZAHN Sofort add-on to die Bayerische’s dental plans. It pays for recommended and started treatment as long as no bill has been issued: up to €750 per calendar year and up to €1,500 over 24 months. You can only take it out together with the main plan when you first sign up; it cannot be added later.

Treatment counts as angeraten (recommended) once the dentist has found a specific problem with a tooth and advised treating it. There does not have to be a Heil- und Kostenplan (treatment and cost plan): an entry in the Patientenakte (patient file) is enough, and the practice is required to record diagnoses and findings there. Many application forms also ask about planned or already known treatment. If you are unsure what the dentist said, I would ask to see the patient file, which you are entitled to do. Then I would answer the application questions from the file, not from memory.

It has plenty of ways to do so. When you submit a Heil- und Kostenplan (treatment and cost plan) or a bill, the insurer may ask the dentist for information with your consent, and the Patientenakte (patient file) shows when the problem was found and the treatment recommended. The practice must keep the file for ten years after treatment ends, so switching dentists changes nothing. If you left recommended treatment off the application, the insurer can withdraw from the contract (Rücktritt): in health insurance within three years of signing, or ten if you acted deliberately or fraudulently. The recommended treatment itself is excluded anyway.

No, these are two separate rules. The Wartezeit (waiting period) is the time after the policy starts when the insurer does not pay yet; in many contracts it is eight months. A plan without one pays from day one, but only for problems found after you signed. Treatment recommended or started earlier is excluded there too. The Zahnstaffel (cap on payouts in the first years) still applies: for the first three to five years, reimbursement is often limited to amounts that rise year by year. Treatment already recommended is only covered by special solutions such as the ZAHN Sofort add-on.

The ZAHN Sofort add-on costs €29.90 a month at any age, and the premium stays the same for its 24 months. On top comes the premium for die Bayerische’s main plan, which depends on your age. In total the add-on costs €717.60 and pays up to €1,500, no more than €750 per calendar year, at the main plan’s rates of 75% to 100%. That does not go far for an implant. In the insurer’s own example, an implant with a crown cost about €3,950: the Krankenkasse (statutory health insurer) paid €472, the add-on €750, and the patient the remaining €2,728.

The Krankenkasse (statutory health insurer) pays a Festzuschuss (fixed subsidy): 60% of the average cost of the Regelversorgung (standard care) for your diagnosis, 70% with five years of an unbroken Bonusheft (dental bonus booklet) and 75% with ten. If the Kasse approves the Heil- und Kostenplan (treatment and cost plan) after 31 December 2026, the rates are 50, 60 and 65%. If you choose an implant or another option above the standard, the subsidy stays the same and you pay the rest. On a low income the Kasse covers standard care in full: in 2026, up to €1,582 gross a month for a single person and up to €2,175.25 with one dependant.