Hardship Calculator for Dentures 2026
Check whether your statutory health insurer grants the full or sliding-scale hardship rule – with your income limit and the full calculation.
1. Household & income
Count e.g. your spouse or partner, children and other relatives living in the same household – not yourself.
Your income limit 2026: €1,582.00
All gross income used for living costs of every household member, e.g. wages, pensions, investment and rental income, maintenance payments. Your health insurer decides what exactly counts.
§ 55 Abs. 2 SGB V
Not counted under § 55(2) SGB V, among others: compensation payments under SGB XIV, pensions and allowances under the Federal Compensation Act for damage to body and health (up to the comparable compensation amount), and compensation for health damage under the Soldiers’ Compensation Act.
2. Fixed subsidy & treatment
How would you like to enter the fixed subsidy?
The treatment and cost plan (Heil- und Kostenplan) shows the total fixed subsidy. Tell us which bonus level that amount is based on.
The amount corresponds to
We derive the other levels proportionally from the amount in your plan. Deviations of a few cents from the official per-finding amounts are possible.
Bonus booklet
Planned treatment
If you enter the costs, we also calculate your expected out-of-pocket share.
Your result
Please enter your monthly gross income.
Income limits 2026
| Household | Monthly gross income up to |
|---|---|
| no family members | €1,582.00 |
| with 1 family members | €2,175.25 |
| with 2 family members | €2,570.75 |
| with 3 family members | €2,966.25 |
| each further family member | + €395.50 |
Non-binding calculation
This calculator does not replace legal or social advice. Your health insurer decides based on your treatment and cost plan and your documents. As of 2026 (reference value 3,955 €/month).
Full vs. sliding-scale hardship: the difference
For dentures, crowns and bridges, German statutory health insurance pays a finding-based fixed subsidy (Festzuschuss): 60 % of the amounts set for standard care (Regelversorgung), or 70 % (5 years) and 75 % (10 years) with a complete bonus booklet. For people on low incomes, § 55 SGB V provides two hardship rules.
Full hardship (§ 55(2) SGB V): if the household’s monthly gross income does not exceed the income limit, or you receive one of the listed social benefits, the insurer pays an additional 40 % on top of the fixed subsidy. For standard care this means the costs actually incurred are covered. If you choose similar or different care (gleich- or andersartig), the insurer pays only the 100 % fixed subsidy; you pay the extra costs yourself.
Sliding-scale hardship (§ 55(3) SGB V): if your income is only slightly above the limit, you receive an additional amount on top of the fixed subsidy. It is calculated like this: the difference between income and income limit is multiplied by three and deducted from the 60 % fixed subsidy. If the result is positive, the insurer reimburses this amount. In total it pays at most 100 % and never more than the actual costs.
Which income counts?
What counts is the monthly gross income for living costs – not only yours, but also that of family members living in the same household and of your partner’s family members. In return, the limit rises by 15 % of the reference value for the first family member and by 10 % for each further one.
Explicitly not counted, among others: compensation payments under SGB XIV, pensions and allowances under the Federal Compensation Act for damage to body and health (up to the comparable compensation amount), and compensation for health damage under the Soldiers’ Compensation Act. Your health insurer checks what counts in your case based on your documents.
Bonus booklet and sliding-scale hardship
The law calculates the additional sliding-scale amount from the 60 % fixed subsidy. How a bonus (70 or 75 %) is credited on top is not settled clearly by the law or the official guidance available to us. The calculator therefore shows the minimum amount: the higher of the bonus fixed subsidy and the 60 % fixed subsidy plus the additional amount. Your health insurer makes the binding decision.
How to apply
- Ask your dentist for a treatment and cost plan (Heil- und Kostenplan). If they consider a hardship case likely, they mark it in the plan.
- Full hardship: submit the plan together with proof of income for all household members, or your benefit notice, to your health insurer before treatment starts.
- Sliding-scale hardship: apply to your health insurer. The additional amount is reimbursed once you submit the invoice.
Worked examples
Example 1: single, just above the limit
Monthly gross income €1,703, no family members, fixed subsidy (60 %) €600, standard-care costs €1,000, no bonus.
- Income − limit: €1,703 − €1,582 = €121
- × 3 = reasonable burden: €363
- Additional amount: €600 − €363 = €237
- Insurer’s share: €600 + €237 = €837
- Out-of-pocket share: €1,000 − €837 = €163 (instead of €400 without hardship)
Example 2: couple with a child, toothless upper jaw, 10-year bonus
Household with two family members, monthly gross income €2,700, finding 4.2 (toothless upper jaw), standard care, 10-year bonus. Fixed subsidy 2026 for this finding: €576.44 (60 %), €720.56 (75 %), €960.74 (100 %).
- Income limit with two family members: €2,570.75
- Income − limit: €2,700 − €2,570.75 = €129.25
- × 3 = reasonable burden: €387.75
- Additional amount: €576.44 − €387.75 = €188.69
- 60 % fixed subsidy + additional amount: €765.13 – more than the bonus fixed subsidy (€720.56)
- Here the sliding-scale rule applies to household incomes below €2,762.90.
Whether the insurer also credits the bonus is its own decision; €765.13 is the minimum.
Frequently asked questions
What is the income limit for the dental hardship rule in 2026?
€1,582 gross per month for a single person (40 % of the €3,955 reference value). With one family member in the household €2,175.25, with two €2,570.75, with three €2,966.25; each further family member adds €395.50.
How is sliding-scale hardship calculated?
The difference between your monthly gross income and the income limit is multiplied by three and deducted from the 60 % fixed subsidy. If the result is positive, the insurer pays it on top of the fixed subsidy – at most 100 % in total and never more than the actual costs.
Does my partner’s income count?
Yes. The gross income of all family members living in your household, and of your partner’s family members, is counted. In return, the income limit rises with each family member.
Who qualifies regardless of income?
People receiving Bürgergeld / basic income support for jobseekers (SGB II), subsistence assistance (SGB XII), basic income support in old age and for reduced earning capacity, subsistence benefits under § 93 SGB XIV, BAföG or vocational training allowance – and people whose care-home costs are paid by social assistance, social compensation or soldiers’ compensation.
Does the insurer pay for implants or all-ceramic work in a hardship case?
Only up to the 100 % fixed subsidy. Standard care is fully covered under full hardship; for similar or different care such as all-ceramic or a crown on an implant, the insurer pays only the 100 % fixed subsidy and you pay the extra costs.
Does my bonus booklet count on top of hardship?
Under full hardship the bonus does not matter for standard care, because the costs are covered anyway. For sliding-scale hardship the law calculates from the 60 % fixed subsidy; how a bonus is credited is decided by your insurer. The calculator therefore shows the minimum amount.
When do I have to apply?
Full hardship before treatment starts: submit the treatment and cost plan with proof of income or your benefit notice to your insurer. Sliding-scale hardship is also applied for at your insurer; the additional amount is reimbursed once you submit the invoice.
How accurate is this calculator?
It calculates exactly according to § 55 SGB V with the 2026 values and – in “select findings” mode – with the official fixed-subsidy amounts. The result is still non-binding: which income counts and how a bonus is credited under sliding-scale hardship is decided by your health insurer.