Is the HKP free of charge?

Yes. Creating a treatment plan is part of the dentist's obligation and is not billed separately. If you receive an invoice for «consultation with plan», you have the right to demand cancellation and to file a complaint with the Zahnärztekammer Hamburg.

How is the Festzuschuss calculated with Bonusheft?

The base GKV subsidy is 60 percent of standard treatment cost (Regelversorgung). With 5 consecutive years of check-ups stamped in the Bonusheft, subsidy rises to 70 percent, with 10 consecutive years to 75 percent. The difference in real money can amount to 200-400 € for a full denture.

What is Regelversorgung and how does it differ from the actual plan?

Regelversorgung is the basic standard the insurance subsidises: metal-ceramic crown front, metal crown back, removable partial denture instead of implant. The dentist's actual plan (Therapieplan) often includes better materials. The difference is your Eigenanteil.

How long is an approved HKP valid?

Exactly 6 months from insurance approval. In exceptional cases (illness, long travel abroad) you can apply for a 6-month extension. If the period expires without treatment having started, a new plan must be drawn up.

Can I switch dentists after the HKP is approved?

Yes, but carefully. If you have already started treatment under the HKP at one dentist, switching requires coordination with the insurance fund. It is often easier to finish the current phase with the first dentist and start the next phase elsewhere. Without coordination, the insurer may refuse the subsidy.

Is it worth asking for a Zweitmeinung (second opinion)?

Yes, if the plan is expensive (over 2000 €) or a radical solution is proposed (tooth extractions, dentures). A second opinion is your statutory right. GKV even covers this consultation. Go to a dentist from a different practice, with no shared interest.

What if the actual treatment turns out more expensive than the HKP?

The dentist is obliged to inform you before exceeding the price and to draw up a supplementary plan (Nachtrags-HKP). Any overrun without your written consent is unlawful (§ 630a-h BGB). You have the right to refuse payment for additional services you did not agree to.

How to Read Your Heil- und Kostenplan: Patient Guide

Michael came to me with a folder. «Andrii, my dentist gave me this and told me to sign. I signed. Now I have a bill for 2840 € and I don't understand what for». I started reading his HKP, line by line. What I saw I did not like. Three metal-ceramic crowns had been planned on healthy teeth «just in case», two implants instead of a bridge, and 2840 € Eigenanteil for treatment that could have cost him 600 € under GKV basic standard.

I see stories like this every week. The Heil- und Kostenplan is a document the German system created specifically to protect the patient. If you understand how it is structured. Without that understanding, the HKP turns into a bill for several thousand euros with incomprehensible codes BEMA, GOZ, BEB.

I have worked as a dentist for 16 years. And I tell all my patients: never sign an HKP in the office immediately. Take it home. I treat the way I would want to be treated, so I always start by explaining what every line means. The more you know, the better treatment you get.

What is the HKP and why does it exist?

The Heil- und Kostenplan (literally: "treatment and cost plan") is a mandatory document that the dentist must prepare before any dental prosthetics. Without it, the insurance fund will not pay a single cent. The HKP is simultaneously a treatment plan, a cost estimate, and an application for the GKV subsidy.

Since January 2025, all HKPs are transmitted electronically. the so-called E-HKP.

Befund. Current condition

What is currently in your mouth: cavities, missing teeth, old crowns.

Regelversorgung. Insurance standard

What the insurance is willing to cover at the basic standard. This is your baseline.

Therapieplan. Actual treatment plan

What the dentist is actually planning to do. The gap between R and TP is your Eigenanteil (co-payment).

How the Festzuschuss subsidy works

📋 5 consecutive years of check-ups → subsidy rises to 70%

📋 10 consecutive years → subsidy rises to 75%

📋 The difference in real money can be several hundred euros

Your 4 rights before signing the HKP

When the dentist hands you the HKP and a pen, you have clear rights written in § 630c-e BGB. No one can force you to sign on the spot.

Right 1, take the document home

Do not sign in the office, even if you are told «now or 3-month waiting list». That is manipulation. Take a copy of the HKP home, read it calmly, ask family or another dentist.

Right 2, Zweitmeinung (second opinion)

You have the right to take your HKP to another dentist for a second opinion. GKV even pays for this consultation when the plan is expensive (over 2000 €). A second opinion often saves thousands of euros.

Right 3, refuse part of the treatment

The HKP is a plan, not a verdict. You can agree to crowns but refuse the implant. Or vice versa. The dentist must draw up a new HKP without the procedures you do not want.

Right 4, 6 months to start

After insurance approval, you have exactly 6 months to begin treatment. If you do not start within that period, you need a new HKP. In exceptional cases you can request a 6-month extension.

Red flags: when an HKP is suspicious

16 years of practice taught me to spot when a plan is too aggressive. Here are 5 flags I urge you to watch for.

1. Extracting several teeth «just in case»

If you are advised to extract 3-4 teeth at once and place a bridge, ask for a Zweitmeinung. A healthy tooth, even with small caries, is better treated than removed. Extraction is the last option, not the first.

2. Crowns on healthy teeth «for aesthetics»

A crown is an invasive procedure, the dentist removes 1.5-2 mm of enamel all around. If you are offered crowns on healthy teeth «because it will look nicer», ask about veneers or simple bleaching first. That is often the better option.

3. Premium materials only, no alternatives

An honest dentist always offers at least 2 options: basic (Regelversorgung) and upgraded. If you are told «I only do zirconia, nothing else», go to another dentist. The basic standard is not «worse», just without aesthetic upgrade.

4. Very short decision window

«Sign now because I'm on vacation tomorrow». That is manipulation. A reputable dentist gives you at least 7-14 days to think. The HKP does not spoil from waiting.

5. Request to pay cash without a receipt

In Germany this is illegal. Every dental treatment must be invoiced. If a dentist offers «discount for cash, no receipt», that is a sign of grey practice. Avoid.

Festzuschuss in 2026: real numbers

The GKV subsidy depends on your Bonusheft and the basic rate for each procedure.

Example, molar crown

Basic metal crown under Regelversorgung, about 380 €. GKV subsidises 60-75 percent of that, so 228-285 €. If you want a zirconia crown on the same tooth, its real price is 600-900 €, but the subsidy stays fixed at 228-285 €. Your Eigenanteil: 315-672 €.

Example, full denture

A full upper denture under Regelversorgung costs about 1100 €. Festzuschuss at 60 percent: 660 €. At 75 percent: 825 €. The difference for the upper jaw alone: 165 €. For a full upper plus lower denture, the gap reaches 350-400 €.

Example, implant

Implants are always private GOZ services. GKV subsidises only the bridge (Regelversorgung), about 800 €. If you choose an implant (3000-4500 €), you still get 600-825 € Festzuschuss, the rest is Eigenanteil. The cynical truth: Bonusheft does not cover the gap between bridge and implant.

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