How the fixed subsidy works
People with German statutory health insurance receive a fixed subsidy for dental prostheses, crowns and implant superstructures that depends on the finding (section 55 SGB V). The finding counts, not the treatment chosen: in the Festzuschuss-Richtlinie the Federal Joint Committee (G-BA) assigns a standard care (Regelversorgung) to every finding and publishes its amount (dentist's fees plus dental laboratory work). The fixed subsidy is 60 % of that amount.
If the patient chooses a more elaborate treatment of the same kind or a different kind of treatment, the fixed subsidy stays the same and the patient pays the extra cost (section 55(4) and (5) SGB V).
The amounts apply nationwide to every statutory health insurer: the guideline has one single table with no distinction by type of insurer or region. The G-BA adjusts it every year by 30 November; the 2026 table has applied since 1 January 2026.
Bonus booklet: 70 % and 75 %
For the patient's own efforts to keep their teeth healthy the subsidy rises to 70 %. The check-ups of the last five years before treatment must have been attended: up to age 18 in every half calendar year, after that at least once in every calendar year (section 55(1) sentences 3 and 4 SGB V). In practice this is shown with the bonus booklet (Bonusheft).
75 % applies if the teeth were cared for regularly and the check-ups of the last ten calendar years were attended without interruption (sentence 5). In justified exceptional cases the insurer may grant 75 % despite one single interruption (sentence 7). A missed check-up in 2020 does not cost either bonus (sentence 6).
Hardship case: 100 % of the standard care
If the patient's share would be an unreasonable burden, the insurer pays, on top of the 60 % subsidy, a further 40 % of the standard-care amounts, adjusted to the actual cost of the standard care and capped at the costs actually incurred (section 55(2) SGB V). Together this is the 100 % column of the table; a bonus is not added. If the patient chooses the standard care, the insurer covers it in full.
If a hardship patient chooses treatment beyond the standard care, the insurer pays only the fixed subsidy plus the 40 % amount, i.e. the 100 % value of the table; the patient pays the rest.
In 2026 the burden counts as unreasonable in particular with gross monthly income of up to €1,582 (40 % of the monthly reference value of €3,955), with one dependant in the household up to €2,175.25, plus €395.50 for every further dependant. For recipients of Bürgergeld, social assistance or BAföG it is assumed without an income check. The health insurer decides whether a hardship case applies.
Just above the limit the sliding hardship rule applies (section 55(3) SGB V): the patient pays at most three times the amount by which their income exceeds the limit. Example from the Federal Ministry of Health: income of €1,610, €28 above the limit, patient's share at most €84.
What the calculator does not know
The patient's own share depends on the chosen treatment and on the practice's treatment and cost plan (Heil- und Kostenplan, HKP). The calculator only shows the fixed subsidies.
Which finding applies, and which findings can be combined, is decided by the dentist and the insurer's approval of the plan. The calculator checks neither combinations nor maximum counts such as "at most four times per jaw". The KZBV billing aid contains the official combination tables.
Partial services (findings 8.1 to 8.6, treatment not completed) have no amount of their own: they are a share of the subsidy for the underlying finding, so the G-BA publishes no figure for them.
The official German wording of every finding is binding. The English texts on this page are our own translation.
2027: lower percentages
The GKV-Beitragssatzstabilisierungsgesetz (Federal Law Gazette 2026 I No. 228) lowers the fixed subsidies from 1 January 2027 to 50 %, with bonus to 60 % and 65 %. In a hardship case a further 50 % is added, so the total stays at 100 %. For subsidies approved before 1 January 2027, section 55(1) and (2) continue to apply in their previous version, i.e. the previous percentages (new section 55(6) SGB V).
The G-BA had not yet published the euro amounts for 2027 on 28 October 2026. 2027 amounts will follow here once published.