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Should I postpone dental treatment to the new year because of annual limits?

In short

Should I postpone dental treatment to the new year because of annual limits? For crowns and dentures often yes, if your supplementary dental insurance counts its limits by calendar year: on 1 January the next level opens. But get the treatment and cost plan approved in 2026, because the public subsidy falls by 10 percentage points from 1 January 2027. Never postpone urgent treatment.

Should I postpone dental treatment to the new year because of annual limits?

What it costs

Common limits and premiums from published tariff examples in Germany.

ExampleTypical range
Public subsidy from 1 January 2027, no bonus, 5 and 10 years bonus50, 60 and 65 percent of standard care
Generous ladder, first calendar yearabout EUR 1,500
Example ladder over four years, cumulativeEUR 1,500, 3,000, 4,500 and 6,000
Top tariffs, model customer aged 43about EUR 25 to 58 a month
Solid basic coverfrom about EUR 6 a month

Values as of November 2026 from publicly quoted tariff examples.

The calculation in the table is a guide value from our quoting practice.

Your limits are in your insurance terms.

Worked example

Crown for EUR 2,500, contract since October, calendar year counting

The tariff reimburses 90 percent of the bill and uses the ladder from the table. The treatment and cost plan was approved in December 2026, so the public subsidy stays under the old rules. The amounts are guide values from our quoting practice.

Treatment in December, first calendar yearreimbursement at most EUR 1,500
Own share in DecemberEUR 1,000
Treatment in January, second calendar yearreimbursement EUR 2,250, frame EUR 3,000
Own share in JanuaryEUR 250

Four weeks later saves EUR 750. With an insurance year tariff the limit would stay at EUR 1,500 until October.

How annual limits work

Almost every supplementary dental insurance (Zahnzusatzversicherung) caps its benefits in the first years. This benefit ladder (Zahnstaffel) sets maximum amounts, often cumulative: for example EUR 1,500 in the first year and EUR 3,000 for the first and second together. After that the tariff pays without limit or up to a permanent annual cap.

Because the limits usually add up, an unused amount does not expire. If you claim nothing in the first year, you have the full frame of both years in the second.

Example ladder, cumulativeMaximumTreatment EUR 2,500, 90 percent reimbursed
First yearEUR 1,500reimbursed EUR 1,500, own share EUR 1,000
First and second yearEUR 3,000reimbursed EUR 2,250, own share EUR 250
Up to the third yearEUR 4,500reimbursed EUR 2,250
Up to the fourth yearEUR 6,000reimbursed EUR 2,250

Calendar year or insurance year

Whether 1 January helps depends on one word in your terms. If the tariff counts by calendar year, the next level starts on 1 January, even if you only signed in November. If it counts by insurance year, the next level starts twelve months after the contract began.

With an insurance year, moving treatment to January achieves nothing; the anniversary of the contract is what counts. Ask your insurer in writing beforehand if you are unsure which treatment date applies.

The special case at the turn of 2026 to 2027

From 1 January 2027 the public health insurance subsidy (Festzuschuss) for dentures and crowns falls. Without a bonus booklet it drops from 60 to 50 percent of the standard care cost, with five years of check-ups from 70 to 60 percent, with ten years from 75 to 65 percent. Plans approved by your health insurer in 2026 keep the old rate even if treatment follows in 2027.

So the order is clear: have the treatment and cost plan (Heil- und Kostenplan) drawn up now and approved by your health insurer in December. The approval is valid for six months. You can then have the crown fitted in January and receive the old subsidy and, with calendar year counting, the next level of your ladder.

If the plan is only approved in 2027, your health insurer pays less. Your supplementary insurance only makes up the gap as far as its reimbursement rate and the ladder limit allow.

When waiting gets expensive

Postponing is only acceptable if your dentist considers it harmless. Deep decay or an inflamed nerve does not get cheaper, and a filling can turn into a crown.

If you already have an approved plan, watch the deadline. If the denture or crown is not fitted within six months, the approval lapses.

What to do before 31 December

The end of the year also matters for your bonus booklet (Bonusheft). The highest subsidy requires that from age 18 you had at least one check-up in each of the last ten calendar years without a gap (Section 55 SGB V). If the stamp for 2026 is missing, get it in December.

If your tariff has an annual budget for professional cleaning, check whether it applies per calendar year. If so, book an appointment before New Year if the budget is not yet used.

When not to postpone

If the ladder has already run out, the tariff pays without limit anyway and postponing brings nothing. The same applies after an accident, because many tariffs drop the ladder for accident damage.

If the bill fits within this year's frame, there is no reason to wait either. Have the treatment when it makes medical sense.

Step by step

  1. Check in your terms whether the ladder counts by calendar year or insurance year.
  2. Work out how much of this year's frame you have already used.
  3. Ask your dentist whether a delay is medically acceptable.
  4. For crowns or dentures, have the treatment and cost plan approved by your health insurer in 2026.
  5. Keep the six month deadline for fitting after approval.
  6. Send the cost plan to your dental insurer before treatment and get the reimbursement confirmed in writing.
  7. Have this year's check-up for your bonus booklet before 31 December.

Checklist

  • Counting method of the ladder known
  • Used part of this year's frame calculated
  • Dentist considers the delay harmless
  • Public subsidy approved before 1 January 2027
  • Approved plan still valid on the planned date
  • Bonus booklet stamped for this year

Common mistakes

  • Moving dentures to 2027 without the cost plan approved in 2026
  • Postponing although the tariff counts by insurance year
  • Delaying treatment of an inflammation to save money
  • Letting the approved plan lapse
  • Postponing accident damage although the ladder does not apply to it
  • Forgetting the annual check-up and losing the bonus

Questions and answers

Frequently asked

What changes for the public subsidy for dentures in 2027?

It falls by ten percentage points to 50, 60 or 65 percent of standard care.

Plans approved before 1 January 2027 keep the old rates.

How do I know whether my tariff counts by calendar year?

It is in the tariff terms under the benefit limits.

Wording such as first calendar year or first twelve months shows the difference.

Does the unused amount expire on 31 December?

Usually not, because many ladders add the years together.

Check whether your tariff states the limits per year or cumulatively.

Does the ladder apply after an accident?

In many tariffs it does not.

Then there is no reason to postpone accident related treatment.

How long is an approved treatment and cost plan valid?

Six months.

If the crown or denture is not fitted by then, the approval lapses.

Is a dental check-up in December worth it for the bonus booklet?

Yes, if you have not had one this year.

The 75 percent subsidy needs ten calendar years from age 18 without a gap.

Sources

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