Costs

The performance of local anaesthesia at the dentist is reimbursed by both statutory and private health insurance companies without exception. However, particularly complex procedures often require the introduction of general anesthesia. This form of sedation often appears to be particularly useful for anxiety patients or children.

However, general anesthesia at the dentist is not always reimbursed by health insurance companies. Only in certain cases do the insurance companies agree to cover the costs of a general anaesthetic in full. In general, the statutory health insurance companies only cover the costs of general anesthesia if there is a medical indication (necessity).

The justifiable reasons have been determined accordingly by the health insurance companies. For children who have not yet reached the age of 12 and who refuse dental treatment, the costs of general anesthesia are easily covered. Patients who suffer from mental handicaps or severe movement disorders can also be given a general anaesthetic at the dentist’s, which is paid for by the health insurance companies.

In addition, the statutory health insurance companies bear the costs of a general anesthesia at the dentist‘s if the patient to be treated suffers from severe, medically recognized anxiety reactions and for this reason cannot be adequately treated under local anesthesia. The nature of the dental procedure to be performed may also justify the induction of general anesthesia. For this reason, major surgical procedures at the dentist’s office are usually performed under general anesthesia.

However, if general anesthesia at the dentist‘s is not medically necessary, health insurance companies are not forced to cover the costs. If the patient still wishes to have the treatment under general anesthesia, he/she must pay for it him/herself. The exact costs vary greatly depending on the dental practice.

In addition, patients who wish to be treated under general anesthesia should inform themselves in advance whether this form of sedation is performed at all in the family dental practice. In case of a general anesthesia during a dental treatment, the coverage of costs in case of private health insurance (PKV) depends on the respective tariff. General anesthesia may or may not be included in your own insurance policy and may therefore be paid in full, partially or not at all.

As a rule, general anesthesia is covered by this insurance, especially if there is a medical necessity for such treatment (e.g. allergies to narcotics or extreme fear of the dentist (phobias)). Nevertheless, one should in any case inquire before the treatment about the conditions for a cost absorption. The costs for a general anesthesia are between 250 Euro and 1000 Euro and vary according to duration and effort.

In private health insurance, dental services are evaluated and billed according to the fee schedule for dentists. Each individual treatment step is assessed with a monetary value and the dentist calculates a fee factor of 1.0 to 3.5 on this, which is multiplied by the value and depends on how demanding the treatment was and how willing the patient was. For example, a treatment that lasted longer due to more difficult conditions will be given a higher point value. For the insured, it is advisable to inquire in advance with the private health insurance company how expensive the forthcoming intervention would be. The dentist prepares a cost estimate for this purpose, which the patient can use to inquire with his insurance company.