The diagnosis of \u201croot canal treatment\u201d triggers double the stress for many patients: concern for the tooth and concern for the wallet. While we take care of the former medically, we want to shed light here on the often opaque jungle of cost coverage. <\/p>\n\n
The answer to the question \u201cDoes the insurance pay for it?\u201d is, as so often in medicine: \u201cIt depends.\u201d<\/strong><\/p>\n\n Statutory insured patients are entitled to treatment that is \u201csufficient, appropriate, and economical\u201d (SGB V \u00a7 12). This means: the insurance pays for the preservation of a tooth, but only under strictly defined conditions. <\/p>\n\n The basic requirement:<\/strong> The tooth must be classified as worth preserving<\/strong> and the treatment must have a good prognosis<\/strong>. If the tooth is already too heavily damaged or the root is extremely curved, the insurance often refuses to cover the costs and instead only pays for the removal (extraction) of the tooth. <\/p>\n\n The guidelines are particularly strict for the large molars in the back. Here, the GKV covers the costs for root canal treatment only if<\/em> at least one<\/strong> of the following three points is met: <\/p>\n\n Do none of these points apply?<\/strong> Then the GKV’s service catalog unfortunately provides for the removal of the tooth. Important:<\/em> You can still decide in favor of tooth preservation! In this case, you bear the costs of the entire treatment as a private service. <\/p>\n\n Even if the insurance fundamentally says \u201cyes\u201d to the treatment, you often receive a treatment and cost plan for private co-payments. Why is that? <\/p>\n\n The insurance benefit covers basic care<\/strong> (X-rays, simple preparation, simple filling). However, modern endodontics offers technologies that can increase the chances of success from approx. 60% (basic) to up to 95% (high-end). These procedures are simply not included in the insurance catalog or are not reimbursed. <\/p>\n\n These include the \u201cBig Four\u201d of tooth preservation:<\/p>\n\n Do not be surprised by cost plans. We create a detailed breakdown (treatment and cost plan) before every procedure. Ask us actively: \u201cWhat is covered by insurance, what is private, and what specific benefit does the additional service have for my tooth?\u201d <\/p>\n\n In the end, preserving your own tooth is almost always the better \u2013 and in the long term often even cheaper \u2013 solution than a gap or an implant.<\/p>\n","protected":false},"excerpt":{"rendered":" The diagnosis of \u201croot canal treatment\u201d triggers double the stress for many patients: concern for the tooth and concern for the wallet. While we take care of the former medically, we want to shed light here on the often opaque jungle of cost coverage. The answer to the question \u201cDoes the insurance pay for it?\u201d […]<\/p>\n","protected":false},"author":2,"featured_media":118854,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":7,"footnotes":""},"categories":[187,190,191],"tags":[],"post_folder":[],"class_list":["post-118852","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dental-fit","category-informative","category-endodontics"],"acf":[],"yoast_head":"\nThe principle of Statutory Health Insurance (GKV)<\/h2>\n\n
Special regulations for molars<\/h2>\n\n
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Why do co-payments (\u201cadditional cost agreements\u201d) arise?<\/h2>\n\n
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Privately insured and supplementary insurance<\/h2>\n\n
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Our advice: Transparency before treatment<\/h2>\n\n