Short Answer
Public health insurance (GKV) covers only the most basic, functional materials such as insurance-standard composite fillings for molars.
Aesthetic options like tooth-colored composite or ceramic are classified as "Mehrleistungen" (additional services) and require a personal out-of-pocket payment.
What Most Expats Don't Realize
You assumed that "full coverage" meant your smile would look natural after a filling. You were shocked to receive a supplemental bill for €150 because you chose a white filling instead of the “standard” composite one provided by the state. You lost over a hundred euros per tooth because you didn't realize that the German system defines "medical necessity" as functional health, not cosmetic appearance.
What To Do
- Ask the dentist for a "Kostenaufstellung" (cost breakdown) specifically comparing the insurance-standard material with the aesthetic option.
- Bring a Girocard or cash to the appointment, as these supplemental fees are often billed directly by the clinic.
- "Was kostet die ästhetische Füllung extra?" (How much extra does the aesthetic filling cost?) — ask this before the dentist prepares the material.
The Truth
The system provides "sufficient and economical" care. In the eyes of German public insurance, a basic filling is medically equal to a premium aesthetic one, and the price difference is a luxury you must fund yourself.