Occupational pension and bKV for medical practices

Your dental assistant (ZFA) hands in her notice. The practice next door pays a little more each month, and that's enough. People who come for the money also leave for the money. What makes people stay is more often what they notice in everyday life. In a medical practice, that mainly means two benefits: an occupational pension (bAV) with an employer subsidy, and an employer-funded health insurance (bKV) that counts when the next Heil- und Kostenplan (treatment and cost plan from the dentist) arrives. You can build both, and your own provision along with them. And from 1 January 2027, the statutory health insurance fund will pay only 50 instead of 60 percent of the Regelversorgung (standard treatment) for dentures.

The short answer. A medical practice can retain its team with two benefits people feel in everyday life. First, the occupational pension (bAV) via salary conversion (Entgeltumwandlung): the practice adds a 15 percent subsidy, to the extent that it saves social security contributions. Second, an employer-funded health insurance (bKV) for dentures, because the Festzuschuss (fixed subsidy from the health insurance fund) drops from 60 to 50 percent of the Regelversorgung on 1 January 2027. A Versorgungsordnung (pension scheme rules) limits the liability risk.

I'm Eduard Strekert, financial advisor for Deutsche Vermögensberatung AG in Lüdenscheid, and I support practices, self-employed professionals and business owners in the Märkischer Kreis region. Let's take a calm look at the roadmap behind it.

Why salary alone won't keep your practice team

The competition for good medical assistants (MFA) and dental assistants (ZFA) is fierce. The practice next door can offer a pay rise too, and with the next offer it's gone again. Benefits the team actually uses last longer. A pension with an employer subsidy is one of them, and so is a dental insurance module.

On top of that: if someone on your team asks for salary conversion, you have to allow it anyway. If you shape it actively instead of merely administering it, the obligation becomes a reason to stay. And in the same step, you build your own provision.

Step 1: The bAV for your practice team

At its core, a team member converts part of their gross salary into a pension contribution. Within the statutory maximum limits, this is favored for both tax and social security contributions. Three points turn it into a real offer.

Statutory subsidy. On top of the salary conversion, you as the employer pay a 15 percent subsidy (§ 1a BetrAVG), to the extent that you save social security contributions as a result. Anyone who gives more sends a strong signal.
The collective agreement. If you follow a collective agreement (Tarifvertrag) for your practice team, an employer-funded contribution can be added. The exact amount changes, so we'll look at the current figures together.
The implementation path. For practices, the Direktversicherung (direct insurance policy) is usually the simplest route with the least administration. An industry-wide solution can score extra points, because the contract moves with the employee if someone leaves your team for another practice.

Explained properly, this is a tangible benefit for your team. This is exactly where it's decided whether the bAV fizzles out as a box-ticking exercise or actually keeps people. How bAV, bKV and accident cover for employees work together is explained on the page Find and retain employees.

Step 2: Employer-funded health insurance in the medical practice

The employer-funded health insurance (bKV) is the second building block. The practice takes it out for its team, and the employees use the benefits. For a dental practice, a dental module is the obvious choice, because the team knows exactly what a co-payment means.

What changes for dentures in 2027. The GKV-Beitragssatzstabilisierungsgesetz (law to stabilize statutory health insurance contribution rates) was published in the Federal Law Gazette on 29 July 2026 (BGBl. 2026 I Nr. 228). It amends § 55 (1), (2) and (6) SGB V, and the new version applies from 1 January 2027.

Without a bonus booklet (Bonusheft): 50 instead of the previous 60 percent of the cost of the Regelversorgung
With five years of bonus booklet: 60 instead of the previous 70 percent
With ten years of bonus booklet: 65 instead of the previous 75 percent
For fixed subsidies approved before 1 January 2027, the old rate still applies. Your health insurance fund can tell you how long an approval is valid
The hardship rule (Härtefallregelung) remains: anyone who qualifies still receives double the fixed subsidy. That usually covers the Regelversorgung in full, but never more than the actual cost

For your team, this means the co-payment rises, even for the Regelversorgung. In a GP practice, your medical assistant pays it with the next treatment and cost plan from her dentist. In a dental practice, the team is often treated by you, and then you usually carry the co-payment quietly yourself. A dental module through the practice cushions exactly this part. To be fair: new dental tariffs usually have benefit limits in the first years. The earlier you start, the sooner they're behind you.

If you'd like to see what both building blocks look like for your team, we'll go through it in a free initial consultation.

On tax, as a feature of the product. If the practice pays the contribution, it can stay free of tax and social security as a benefit in kind (Sachbezug) up to the exemption limit of 50 euros a month (§ 8 (2) sentence 11 EStG, as of October 2026). The condition is that your team receives only the insurance cover and no money. The limit applies to all benefits in kind in a month combined, and if it's exceeded, the whole amount becomes taxable, not just the excess. Whether and how this fits your payroll is something your tax advisor clarifies. What a dental supplementary insurance covers in general is explained on the page Supplementary insurance.

Step 3: How do you avoid liability as an employer?

As soon as you promise a bAV, you're on the hook for it. This is called the employer's guarantee obligation (Einstandspflicht). Mistakes in the setup can get expensive later.

The solution is a clean Versorgungsordnung. It is your practice's rulebook and defines who receives which benefit and under what conditions. That keeps the rules clear and your liability risk smaller. This belongs in expert hands, often in cooperation with your tax advisor or lawyer. This article does not replace legal advice.

Step 4: Your own provision as a practice owner

As a doctor or dentist in private practice, you usually pay into your Versorgungswerk (professional pension fund). That's a strong foundation. But it often isn't enough for your accustomed standard of living in old age. On top of it, you build further in a targeted way.

Mind your legal form. If you run a solo practice or a GbR (partnership under German civil law), a bAV for yourself is usually not possible. The reason lies in your tax status as a co-entrepreneur. If your practice operates as a GmbH (German limited company) and you are its employed managing director, the picture is different. Exactly how this looks in your case is something we clarify together with your tax advisor. The bKV is also meant for your team. As the owner, you protect yourself privately.

State-supported basic provision. Contributions to a fund-linked Basisrente (tax-deductible basic pension), often called Rürup, can be deducted as special expenses, up to an annual maximum. How strongly this works for you depends on your tax rate. The catch: the capital is locked in until retirement, and the later pension is taxed. So part of today's advantage is a deferral.

Flexible fund-linked provision. As a flexible counterpart, there's a fund-linked solution you can access when you need to. It makes up for the flexibility that the Versorgungswerk and the Basisrente lack.

A model case from practice

Take a fictional dental practice. Solo practice, six employees, all with statutory health insurance. The owner wants to keep good people and build solid provision for herself.

For the team, she sets up two building blocks. First, a Direktversicherung via salary conversion with the statutory 15 percent subsidy, to the extent that the practice saves social security contributions. A Versorgungsordnung governs who gets what. Second, a dental module as a bKV, which the practice takes out for all six. It cushions the co-payment that rises from 2027. Whether the contribution fits within the benefit-in-kind limit is checked by her tax advisor.

As a solo practice, she can't use a bAV for herself. Her foundation stays the Versorgungswerk. On top of it, she adds a Basisrente and a flexible fund-linked portfolio. How much of it is needed depends on her provision gap and her tax rate. That's exactly what we calculate for her specific case, instead of working with a blanket figure.

Neither the bAV nor the bKV runs on autopilot. Explained poorly, hardly anyone on the team takes up the bAV, and the retention effect fizzles out. Designed poorly, you bring a liability issue into your practice. With the dental module, it's worth reading the small print: how much it reimburses, whether there are maximum limits in the first years and whether a treatment that has already been recommended is covered all depend on the tariff. Many dental tariffs exclude it, and some group tariffs make an exception here. And no benefit replaces a good working atmosphere. That's why we look at the concept together before anything gets signed.

Frequently asked questions about the bAV and bKV in the medical practice

Am I required as a practice owner to offer a bAV?

Yes, when your team asks for it: if someone requests salary conversion, you have to allow it and pass on 15 percent of the converted amount as a subsidy, to the extent that you save social security contributions as a result (§ 1a BetrAVG). You set the funding vehicle within the legal framework, usually a direct insurance policy (Direktversicherung).

What changes for dentures in 2027 for people with statutory health insurance?

From 1 January 2027, the Festzuschuss (fixed subsidy) drops from 60 to 50 percent of the cost of the Regelversorgung (standard treatment). With five years of bonus booklet it is 60 instead of 70 percent, with ten years 65 instead of 75 percent. For fixed subsidies approved before 1 January 2027, the old rate still applies. The hardship rule remains (§ 55 SGB V in the version applicable from 01.01.2027, BGBl. 2026 I Nr. 228).

Is a bKV worth it for a small practice?

For many small practices, yes, because the benefit reaches the team directly and the contribution is easy to plan for the practice. From how many employees a group tariff is possible is set by each insurer. Whether the contribution stays free of tax and social security as a benefit in kind (Sachbezug) is something your tax advisor clarifies.

Can I set up a bAV for myself as a doctor?

That depends on your legal form. In a solo practice or a GbR it usually isn't possible. As the employed managing director of a practice GmbH, it is. We clarify this with your tax advisor.

Is the Versorgungswerk enough as retirement provision for doctors?

It's a strong foundation, but on its own it often doesn't cover your accustomed standard of living. A Basisrente and a flexible fund-linked solution complement it well.

Your next step in the Märkischer Kreis region

You don't have to solve this alone, and certainly not on a single afternoon between two consultation hours. A first conversation doesn't commit you to anything. Afterwards, you'll know what the bAV and bKV look like for your team and how your own provision fits with them.

I'm based in Lüdenscheid and advise practices in the Märkischer Kreis region in person or via video, at their own pace. There's no need to rush anything. Next step: book a free initial consultation, and we'll look at your practice together.

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Eduard Strekert is a financial advisor for Deutsche Vermögensberatung AG (DVAG). This article is general information and does not replace personal advice. It does not constitute investment or tax advice.

Occupational pension and bKV for medical practices: retain your team before the co-payment for dentures rises in 2027