Dental coverage limitations

This article primarily relates to top-up dental insurance for people with public health insurance. For information on coverage as part of a private health insurance policy, consult our guide to dental treatment in Germany.

Dental coverage limitations are restrictions on insurance benefits for top-up dental insurance

A significant proportion of people in Germany with public (statutory) health insurance opt to take out a private top-up insurance policy for dental treatment and services. Many consider the dental coverage in the public health insurance system to be insufficient.

However, the coverage provided by top-up insurance policies is usually subject to specific limitations. In the case of ottonova, these include a specific scale (Zahnstaffel) setting upper limits on maximum reimbursement for the initial years of an insurance policy, plus upper limits for specific services, such as professional tooth cleaning, fissure sealing and orthodontic treatment. The exact limits depend on the top-up insurance tariff you choose.

These limitations protect the insurance collective. Premiums in the private health insurance system are based on risk: if people were allowed to take out a top-up insurance policy and immediately claim extensive benefits with no upper limit, the cost of insurance would rise for everyone.


With our tariffs you have world-wide travel coverage. The Expat Tariff covers you up to two months annually outside the EU and in our Premium Economy-, Business- or First Class Tariffs you will be covered up to six months annually outside the EU.

If you move away from Germany, you will not need German health insurance anymore.

The payment is different than in the public system. With private health insurance you pay the full tariff to us at the beginning of the month. If you are employed your employer will contribute their part to your health insurance through your salary.

In Germany, doctor fees are regulated by GOÄ (Gebührenordnung für Ärtze) and GOZ (Gebührenordnung für Zahnärtze). This is a price range regulation that indicates the cost of a treatment. A normal treatment will be charged with factor 2,3. Anything higher than that up to 3,5 needs an explanation from the doctor on the invoice, explaining the increased effort. Everything higher than 3,5 the doctor needs you to sign the so called “Honorarvereinbarung” before the treatment. We advise you to always let us know if this happens.

We can help you write your cancellation letter for your current insurer and send it to you by email. You simply need to add your insurance number and signature and then send it to your insurer. We are unfortunately not allowed to contact your current insurer directly.

ottonova for Expats

Saving on health insurance and still getting the best coverage isn’t possible? With signing in for ottonova you can make it happen!

Related articles