Information for holders of statutory insurance policies

What is a treatment plan and cost overview (HKP)?

The treatment plan and cost overview (German: Heil- und Kostenplan or HKP for short) is an application form which must be filled out by the dentist when a denture treatment is planned. The treatment plan and cost overview must be submitted to the patient’s health insurance company and approved before the dental treatment can be started. This step only applies to treatment for patients with statutory health insurance policies. The treatment plan and cost overview shows which treatment is to be carried out. Any bonus the patient may be entitled to is also recorded.

You can find detailed information on the individual fields and abbreviations on an HKP here (LINK TO DOCUMENT 1 / KZBV)

Important: After approval by the health insurance company, treatment must begin within six months.

What do statutory health insurance companies pay for?

As soon as the treatment plan and cost overview has been approved by the health insurance company responsible, the denture treatment may be started. The health insurance company then subsidizes the treatment with a so-called fixed subsidy.

The fixed subsidy is determined such that it pays for approximately 50% of a sufficient, effective and economical treatment. It does not pay for treatment beyond that which is necessary. The remaining 50% of the costs are paid by the patient themselves. If treatment is desired which goes beyond the “sufficient” extent, these costs are also to be paid by the patient. For example, the placement of an implant is almost never covered by subsidies from statutory health insurance companies.
This is a 100% private service.

Why you usually also have more documents:

Very often, the patient will also receive further documents from their dentist besides the treatment plan and cost overview. These are additional plans and cost calculations. Further documents are required when treatments or individual measures are planned which are not covered by the treatment plan and cost overview. Often, these are to be paid entirely by the patient.

The multitude of documents can mean that it is often difficult to determine how high the overall costs are which a patient can expect. A treatment plan should therefore include an overview sheet showing a summary of all costs.

Feel free to ask us about this! We can give you individual advice on which treatment options are possible for you and on the best treatment method for you.