Insurance in Germany - Dental Treatment in Poland.
Important Information.
Many Poles who work permanently in Germany and are insured with a German Krankenkasse (e.g., BKK, AOK, Viaactiv) often consider getting dental treatment in Poland. When visiting family, going on vacation, during holidays, or on leave, they would like to take advantage of dental services as well. Many of them are looking for answers to questions such as: What formalities do I need to fulfill for Krankenkasse to reimburse the costs of treatment in Poland?
The first thing to note is that dental treatment in private dental clinics in Poland is very attractive in many aspects. These include:
- Private dental clinics offer flexible appointment scheduling, consultations, and adapt to the patient's time constraints (length of stay, vacation duration, etc.).
- The quality of services provided by Polish specialists is very high.
- The comfort of treatment, as well as dental equipment and materials, are of very high quality.
- Treatment costs are significantly lower than in Germany.
- Comfortable communication and no language barriers related to medical terminology.
What to consider when starting planned dental treatment in Poland if you want Krankenkasse to reimburse your treatment costs.
- Conditions of Your Health Insurance:
Much depends on the conditions of insurance and the chosen health fund. Most Krankenkassen (both public and private) finance dental services in Poland, although there are exceptions. Therefore, before starting treatment, it is worth reviewing the contract or calling your insurance company to inquire about the details. IMPORTANT: If you have additional insurance, the reimbursement for treatment may differ from basic insurance.
- Standard Treatment (conservative dentistry, endodontics, tooth extraction):
Basic dental procedures include essential dental services (e.g., root canal treatment, fillings, tooth extraction). There is no need for prior notification to the health fund for these treatments. Ask your treating dentist to issue an invoice for their service. In some cases, Krankenkasse may require a bill for treatment in German – in this case, you will need to translate such a document with a translator (it does not have to be a sworn translator). Krankenkasse will reimburse the treatment costs based on the submitted invoice. However, you must cover the costs out of your pocket first.
- Prosthetic Treatment and Aesthetic Dentistry (dentures, crowns, veneers, implants):
Prosthetic treatment is entirely different. Before starting prosthetic treatment (related to replacing missing teeth with bridges, implants, crowns, and dentures), you must notify the health fund of your intention to undergo such treatment and obtain their approval. Approval is based on a cost estimate (Heil- und Kostenplan) prepared by the dentist in Poland who will perform the treatment. Krankenkasse calculates your subsidy based on the cost estimate and the bonus booklet attached (here, we have additional discounts, e.g., for regular check-ups and visits to the dentist). It usually takes a few days – usually not more than two weeks – to receive approval for treatment. This is crucial because starting treatment before receiving approval may result in a denial of benefits. By accepting the cost estimate, the health fund immediately informs you of the portion of the costs you will need to cover out of your pocket (usually 30-50%). After completing the treatment, the patient must present invoices confirming the services provided, in accordance with Krankenkasse's requirements.
Frequently Asked Questions:
How much will Krankenkasse pay for dental prostheses?
Krankenkasse subsidizes the costs of prostheses with a fixed amount, known as a fixed subsidy. The amount of the subsidy depends on dental findings and is paid for medically necessary prostheses (e.g., crowns, bridges, partial and full dentures) as part of standard care. Your refund also depends on whether you had regular dental check-ups.
Where to start the procedure for prosthetic treatment in Poland at Krankenkasse's expense?
Your dentist in Poland will prepare a treatment plan (Heil- und Kostenplan). Send the treatment plan to Krankenkasse along with your bonus booklet. After checking and processing, you will receive information from the insurer about the acceptance of your treatment plan (or any necessary adjustments) and the subsidy you are entitled to.
How much is my subsidy for dentures?
The amount of the fixed subsidy depends on your insurance, additional insurance, and information about regular dental check-ups (bonuses). Usually, the subsidy covers 60% of the standard care costs.
- Your fixed subsidy increases to 70% if you have had regular dental check-ups once a year in the last 5 years.
- Your fixed subsidy increases to 75% if you have regularly visited the dentist for check-ups in the last 10 years.
Does Krankenkasse reimburse for implants or aesthetic dentistry treatment?
No, implants are considered private services. Krankenkasse will not reimburse you for these. If the cost of implants is too high for you, talk to your dentist about alternatives (e.g., bridges or dentures).
Need more information?
Contact us: +48 607 871 284, kontakt@medicaladvisor.pl.
Zespół MedicalAdvisor.pl Team
