Planning, clarifying costs, getting treatment, billing: Find out below how the subsidy for your dental prosthesis works.
More details
1. Plan the treatment with your dentist
When you are due for a dental prosthesis, your dentist will provide information about the medically necessary tooth replacement in a "Heil- und Kostenplan" [treatment schedule and cost estimate]. The cost estimate will include the anticipated material and laboratory costs and the dentist's fee. This treatment plan must be sent to us before treatment begins.
2. Have the treatment schedule and cost estimate approved by TK
Thanks to a data exchange process that came into effect on 1 July 2022, treatment schedules and cost estimates can now be transmitted between dental practices and health insurance providers directly. In most cases, your dentist will receive information about the amount we can subsidise on the same working day. This information will be sent to you by post or to your electronic mailbox in "Meine TK".
Is your dental practice not yet using the electronic process? In that case, please send the treatment schedule and cost estimate (pink form) to the address below (street and house number not required) together with your bonus booklet.
Techniker Krankenkasse
20905 Hamburg
A copy of your bonus booklet is also sufficient. We will review the treatment schedule and cost estimate and set the subsidy. The bonus you have earned through regular dental check-ups will be taken into account right away.
Once the treatment schedule and cost estimate has been approved, it is valid for six months. You should therefore make an appointment at your dental practice right away.
Appraisal before approval
In some cases, we may request an expert appraisal before agreeing to subsidise the treatment. The appraiser may, for example, determine whether the planned treatment is necessary and cost-efficient. The appraiser is not permitted to interfere with the treatment. However, they may make suggestions regarding possible alternatives.
3. Inform your supplementary insurance provider
If you have supplementary insurance and require extensive tooth replacement work, it may be a good idea to submit the treatment schedule and cost estimate to your provider beforehand. Please get in contact with your dentist to receive a copy of the treatment schedule and cost estimate.
4. Treatment
Your treatment can only begin after TK has received the treatment schedule and cost estimate. If another dental problem is found during the treatment, the dental practice must issue a new, amended treatment schedule and cost estimate and submit this to us.
5. Billing
If your dental practice settles the fixed subsidy which we approved with the treatment schedule and cost estimate with TK via the "Kassenzahnärztliche Vereinigung" [Association of Statutory Health Insurance Dentists], there is nothing else you have to do. Your dentist will give you a separate invoice for your co-payment.
If you have supplementary dental insurance, you should submit this invoice to your provider. If you are insured by our cooperation partner Envivas, you can download the supplementary insurance claim form right here: Supplementary insurance claim form
Should you decide on a form of tooth replacement treatment which requires you to pay all the costs up front as stipulated in the agreement with your dentist, please send us the final invoice and laboratory invoices for reimbursement. The easiest way to do this is through "Meine TK" or the TK-App (available only in German language):
Submit an online request for the reimbursement of for your dental prosthesis costs