What does dental insurance actually cover? Is a check-up paid for, do you receive reimbursement for the dental hygienist, and what about crowns or implants?
The coverage of dental costs depends on your age, the treatment, and your health insurance. At We Smile Tandartsen in Leiden, we believe it is important that you know what costs to expect in advance.
In this article, we explain which dental treatments are typically covered in 2026 and what you should look out for.
Which dental costs are covered by basic insurance?
Basic insurance distinguishes between children and adults.
Dental coverage for children up to 18 years old
For children up to 18 years old, most regular dental treatments are covered by basic insurance.
This includes, among others:
- Periodic check-ups
- Fillings
- X-rays when necessary
- Dental cleaning and preventive oral care
- Root canal treatments
- Tooth extractions
No mandatory deductible applies to this regular oral care.
Please note: orthodontics, such as braces, are usually not covered by basic insurance.
Read also why a periodic dental check-up is important for healthy teeth.
Dental coverage for adults from 18 years old
From the age of 18, standard dental treatments usually fall outside of basic insurance.
This applies, for example, to check-ups, fillings, crowns, and regular dental cleanings.
There are exceptions. For instance, basic insurance may provide coverage under certain conditions for:
- Oral surgery treatments
- Certain full dentures
- Special dentistry for specific medical indications
For care covered by basic insurance, the mandatory deductible may apply. In addition, a statutory personal contribution applies to some treatments.
What does supplementary dental insurance cover?
Supplementary dental insurance can cover part of your dental costs.
Which treatments are covered varies by insurer and package.
Many supplementary insurance policies offer coverage for:
- Dental check-ups
- Fillings and X-rays
- Treatments by the dental hygienist
- Root canal treatments
- Crowns and bridges
- Sometimes implants
Insurers often work with a maximum amount per calendar year. A reimbursement percentage may also apply, for example, 75% or 100% up to a certain maximum.
An insurance policy that covers 100% does not automatically mean that all dental costs are paid without limit.
Want to know more about professional cleaning? Read our article What exactly is a dental cleaning?.
Is orthodontics covered by health insurance?
Braces for children and adults are usually not covered by basic insurance.
An exception may only apply under strict conditions in cases of severe developmental or growth disorders of the teeth or jaw.
Some supplementary insurance policies offer orthodontic coverage. Age limits, maximum reimbursements, and waiting periods may apply.
This is also important when considering treatment with transparent aligners.
Read more about Invisalign and invisible braces for adults.
Are dental implants covered?
An implant to replace a missing tooth is usually not covered by basic insurance for adults.
Some supplementary dental insurance policies cover part of the costs.
A significant exception is an implant-supported overdenture, also known as click-in dentures. With an appropriate medical indication, coverage for this may be possible through basic insurance.
Prior authorization, a personal contribution, and the deductible may apply.
Are you considering an implant? Read our complete guide to implants in Leiden.
Which dental treatments are usually not covered?
Not all dental treatments are eligible for reimbursement.
Examples include:
- Cosmetic treatments such as teeth whitening
- Treatments exceeding the maximum insured amount
- Treatments excluded according to your policy
- Certain aesthetic treatments without medical indication
- It is also important to check in advance whether your insurance offers coverage for crowns, veneers, and implants.
How do you check what your dental insurance covers?
Do you want to know what amount your insurer will pay? Check your policy conditions or your health insurer’s online portal.
Pay particular attention to the following points:
- Reimbursement percentage: what part of the treatment is paid for?
- Annual maximum: how much coverage do you still have available?
- Exclusions: which treatments fall outside of the coverage?
- Waiting periods: do you need to be insured for a certain period first?
- Authorization: is prior approval required for extensive treatment?
For larger treatments, it is wise to submit an estimate to your health insurer in advance.
The insurer can then indicate which part is expected to be covered.
Clarity on dental costs at We Smile Tandartsen in Leiden
At We Smile Tandartsen, we value transparency regarding treatments and costs.
When a more extensive treatment is necessary, we discuss the options and you will receive an estimate in advance where necessary.
This allows you to check for yourself what coverage your health insurance offers and which costs remain for your own account.
Are you looking for a dentist who provides clear explanations about your treatment options?
Make an appointment at We Smile Tandartsen in Leiden for personal advice.
Good preparation helps prevent surprises regarding dental costs.
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