Dental Prosthetics can be quite expensive, because even with health insurance, patients often have to pay a significant portion out of pocket. However, anyone with a monthly gross income of less than 1,582 euros can apply to have their health insurance cover the full cost. This is reported by the AOK, among others. However, the insurance plans only cover the costs of standard care. Anyone who wants more extensive dental prosthetics must pay for them out of pocket.
The hardship provision also applies to recipients of citizen’s income, BAföG, social assistance, war victims’ benefits, and basic income support for the elderly. With one dependent, this limit increases to 2,175.25 euros, and by an additional 395.50 euros for each additional dependent living in the household. Dependents include spouses and same-sex partners under the Civil Partnership Act, as well as children covered by family health insurance.
The increased subsidy must be applied for with the health insurance provider before treatment begins. The form for this is available from the health insurance provider or at the dental practice.
Higher Subsidy Possible
Even those whose income slightly exceeds the income limit for the hardship provision may be eligible for an increased fixed subsidy. This is known as the “individual hardship provision.” Patients do not receive double the fixed subsidy as in the standard hardship provision, but they do receive more money. The amount depends on income and the cost of the dental prosthesis. Anyone who has slightly more than the stated 1,582 euros available in 2026 should therefore contact their health insurance provider.
Hardly any entitlements for asylum seekers
Asylum seekers are only entitled to dental prosthetics during the first three years “if it is urgent for medical reasons in individual cases,” according to the Asylum Seekers Benefits Act. After that, they fall under the hardship provision—if they are eligible for dental prosthetics.
For recognized asylum seekers, the same rules apply as for all other health insurance policyholders: it depends on the level of income. For recipients of basic income support, the hardship provision applies. For employees, it depends on how much they earn.
Further information:
https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/aerzte-und-kliniken/haertefallregelung-beim-zahnersatz-wer-hat-anspruch-12887
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