Statutory health insurance companies pay for orthodontic treatment for insured persons who have not reached the age of 18 at the start of treatment if the treatment is medically necessary.

Whether treatment is medically necessary for your child is assessed by the orthodontist on the basis of so-called orthodontic indication groups (KIG) and their 5 degrees of severity. Statutory health insurance companies pay the costs for your child from severity level 3, which means, for example, that a misaligned jaw or teeth is already significantly impairing your child's biting, mouth closure or joint function or threatens to do so in the future.

The orthodontist will settle the orthodontic treatment directly with the National Association of Statutory Health Insurance Dentists, minus your own contribution. Your own contribution is 20 percent of the costs paid by the panel doctor. If you have more than one child undergoing orthodontic treatment, your own contribution for the second and each additional child is reduced to 10 percent of the costs incurred by the panel dentist. The prerequisite is that they live in the same household.

Once the treatment has been successfully completed, the statutory health insurance fund will reimburse your own contribution. To do this, you must submit an application to your health insurance fund or your child's health insurance fund and submit a number of documents, for example the final report from the orthodontist and the co-payment invoices with corresponding proof of payment.

Cost coverage for adults

The costs of orthodontic treatment started from the age of 18 can only be covered by statutory health insurance in very few exceptional cases. These include, for example, severe jaw anomalies that require surgical correction. In these cases, your orthodontist will create a coordinated oral surgery and orthodontic treatment concept.