Must the Heil- und Kostenplan be approved before the treatment?
Yes. According to the source cited here, the Heil- und Kostenplan, the treatment and cost plan the fund must approve, has to be approved before the treatment — not submitted afterwards. The Bonusheft, the bonus booklet, changes the amount: according to the same source, with a Bonusheft kept without gaps for ten years, the contribution rises from 60% to 70%. The plan itself only comes into existence after a prior individual examination and diagnosis.
The order of events is the real answer
This question is almost always asked too late. It belongs at the very start, before the flight and before any appointment is confirmed, because the contribution hangs on the order of events. First the examination, then the plan, then the approval, then the treatment. If the third step is skipped, it cannot be obtained afterwards.
That sounds bureaucratic, and it is. But it is also the reason a treatment in Portugal can be worked out at all for someone in the statutory scheme: the contribution stays in place when the route is followed.
This page describes the condition, not the procedure. How your own fund accepts the plan, in what form and in which language, and what other documents it asks for, can only be answered by the fund itself. No source on that is available here, and what is not documented is not written here.
Where the plan comes from
A Heil- und Kostenplan is not a quote one can simply request. It describes a finding, and a finding is produced in the consulting room: with the examination and the 3D scan, which shows the bone as a volume. Before that there is nothing a fund could assess.
The Instituto AreLuna prepares the detailed quote to be submitted. Which restoration appears in it, how many implants and in what stages, follows from a prior individual examination and diagnosis and from nothing else.
A practical consequence for planning follows: the diagnosis and the approved treatment do not fall on the same day. Anyone who expects two separate trips is being realistic. How many trips are needed has a page of its own.
What the Bonusheft changes
The Bonusheft is the second lever, and it is worked on years before the decision. According to the documented source, with a Bonusheft kept without gaps for ten years, the contribution rises from 60% to 70%.
The source is a published overview of implant costs and the Festzuschuss, a fixed contribution rather than a percentage, as at January 2026. It gives the same relationship for the size of the Festzuschuss — around 632 € for a single implant, 550 € to 1 000 € for a restoration on four implants. What is approved in an individual case is stated by your own fund on the basis of the plan submitted — and that plan presupposes a prior individual examination and diagnosis.
Anyone who has not kept the booklet complete does not lose the entitlement as a result. The share changes, not the right. And anyone unsure of their own position can find out from the fund in a single call, long before any trip is due.
What this means for planning
Four things, in this order. Ask the fund in writing what it requires for treatment in another EU member state and in what form the plan is submitted. Clarify your own Bonusheft status. Only then arrange the diagnostic consultation. And wait for the written quote before any treatment date is fixed.
None of this requires a trip, except the third step. The first two can be dealt with from a desk, and they decide whether the rest can be worked out at all.
The diagnostic consultation is booked by telephone, on +351 220 430 090. Dental care is provided by the Instituto AreLuna at Rua de Júlio Dinis, 194, 4050-327 Porto; the establishment is registered with the Entidade Reguladora da Saúde, the Portuguese health regulator, under number 161637 and holds operating licence 21593.
Frequently asked questions
What happens if treatment starts before approval?
This page names no consequence, because no source on it is available here. It names the condition: according to the documented statement, the plan must be approved before the treatment. What follows from a different order is answered by your own fund — and beforehand.
Does the clinic draw up the Heil- und Kostenplan?
The Instituto AreLuna prepares the detailed quote to be submitted. Whether your own fund accepts that form or asks for its own form is something to ask it before an appointment is booked.
Is the Bonusheft worth completing retrospectively?
No, it is kept up over years and cannot be filled in afterwards. According to the documented source, with ten years of unbroken entries the contribution rises from 60% to 70%. Without a complete booklet the entitlement remains; only the share is smaller.