New legislation
Dental coverage for 2026 has changed in patients’ favor. Adults are now entitled to a basic white photocomposite filling covered by public health insurance. If they choose a more expensive material or a more complex treatment method, they may only have to pay the difference between the covered option and the one they selected. The changes also apply to root canal treatments, and as of July 2026, the use of amalgam will be prohibited, with some exceptions.
In other words, the copayment for better dental treatment no longer means that the patient must automatically pay for the entire procedure. If a covered basic option exists and the patient chooses a more expensive treatment method, the health insurance provider may cover the portion corresponding to the basic procedure, and the patient pays only the difference.
If you’re unsure whether your dentist is billing you correctly or whether they should have offered you a treatment option covered by public health insurance, we can review your specific case through our legal advice service and explain what care you’re entitled to.
One of the most significant changes is that white fillings are now covered by insurance for adult patients as well. For permanent teeth, public health insurance covers a basic, non-layered photocomposite filling. The reimbursement for this procedure in 2026 is 900 Kč.
However, this does not mean that every white filling is automatically free. The specific type of filling and the method used to place it are decisive factors.
For adults, two main situations may arise:
If a photocomposite filling is not medically appropriate, the reimbursement rules also provide for other materials. The amount of reimbursement is then determined by the specific procedure performed.
For patients under 18 years of age, the scope of covered care remains broader. Photocomposite fillings for permanent teeth are covered for the entire dentition, and the reimbursement amount also depends on the size of the filling.
In 2026, for example, the reimbursement is 1,300 Kč for a filling covering one surface, 1,950 Kč for two surfaces, and 2,350 Kč for a filling covering three or more surfaces.
The new rules allow for the use of a partial reimbursement system. This means patients are no longer limited to choosing between a “free basic option” and paying for the entire procedure out of pocket.
If a covered basic option exists but the patient wants, for example, a more complex layered photocomposite filling, the health insurance company will cover the portion of the procedure corresponding to the basic treatment. The patient then pays the difference between this coverage and the cost of the chosen option.
Example: The dentist recommends a basic white filling that meets the conditions for full coverage. However, the patient requests a more aesthetically advanced layered filling. The insurance company will contribute an amount corresponding to the basic covered option, and the patient will pay the remaining portion of the cost.
This is precisely where the most misunderstandings can arise in practice. Therefore, before treatment, the patient should know which option is fully covered, how much the insurance company will contribute toward the selected, more expensive option, and how much the patient’s copay will be. It is not enough to simply be told that it is a “better filling for an additional fee.”
If your dentist did not offer you the fully covered option or it is unclear how the required copay was calculated, keep the price list, the bill, and information about the procedure performed. Our attorneys can guide you through any necessary steps to take against the provider or health insurance company.
The changes do not apply only to fillings. Starting in 2026, endodontic treatment—that is, root canal treatment—will also be covered.
For adults, basic coverage applies to permanent incisors, canines, and premolars. Treatment using the central post method is covered at a rate of 1,300 CZK per filled root canal.
If a patient chooses a different method for these teeth, the procedure may be covered only partially. The insurance company will contribute an amount corresponding to the basic procedure, and the patient will pay the remaining balance.
For molars, this coverage does not apply to adults, so patients generally pay for their endodontic treatment out of pocket.
For patients under 18, the rules are more favorable. Primary endodontic treatment of a permanent tooth is covered for all teeth, and any appropriate method may be used. The reimbursement is 2,000 CZK per filled root canal.
Another important change took effect on July 1, 2026. Amalgam fillings can no longer be used routinely.
A dentist may choose amalgam only if they consider it absolutely necessary in light of a specific patient’s health needs. The reason for its use must also be documented in the patient’s medical records.
If the patient’s health condition allows for the use of another material, an alternative to amalgam should be used.
This restriction is based on European regulations on mercury, and Czech reimbursement rules have aligned with them by expanding the range of covered alternatives.
Before undergoing a paid procedure, the patient should know whether there is an option covered by health insurance and what the cost will be for the chosen non-covered or partially covered treatment.
Before treatment, it’s therefore worth asking the following questions in particular:
The rules are based on the Public Health Insurance Act, which is supplemented by the Reimbursement Decree for 2026. This decree sets the specific reimbursement amounts for individual dental procedures.
The 2026 dental reimbursement rates have brought about a significant change, particularly regarding fillings and root canal treatments. Adults are entitled to a basic, single-layer white photocomposite filling covered by health insurance in the amount of 900 Kč. For more expensive options, partial reimbursement is available, and the patient pays the difference. A similar principle applies to certain root canal treatment methods. Children and adolescents under 18 years of age have a broader scope of covered dental care. Additionally, as of July 1, 2026, amalgam fillings will be used only in exceptional cases where their use is necessary for medical reasons.
It depends on the type of filling you choose and whether your dentist is a contracted provider for your health insurance company. For a basic, non-layered photocomposite filling that meets the reimbursement criteria, an adult insured person is entitled to have the procedure covered.
No. If a fully covered option is available in your case, you can choose it. You should also find out in advance the cost of any more expensive alternatives.
Yes. The health insurance company covers a set amount, while the provider determines the cost of the premium option. The resulting copayment may therefore vary from one doctor’s office to another.
Not always. The extent of coverage also depends on the provider’s contractual relationship with your health insurance company. Therefore, it’s a good idea to check before your appointment whether the practice has a contract with your specific insurance company.
Ask for an explanation of the procedure performed and its cost. If you have any doubts about the accuracy of the procedure or billing, you can also contact your health insurance provider.
Our team of experienced attorneys will help you solve any legal issue. Within 24 hours we’ll evaluate your situation and suggest a step-by-step solution, including all costs. The price for this proposal is only CZK 690, and this is refunded to you when you order service from us.
In person and online. Just choose the appropriate service or opt for an independent consultation when you are unsure.
