Apply for orthodontic treatment
Description
The health insurance covers the costs for medically necessary orthodontic corrections (orthodontic treatments) up to the age of 18. The decisive factor here is the start of the treatment.
The medical necessity of kfO treatment is assessed on the basis of five degrees of severity, the so-called orthodontic indication groups (KIG).
From grade 3 (KIG 3), the health insurance company pays the costs for children and adolescents under the age of 18 for the treatment.
Adults usually have to pay for orthodontic treatment themselves.
Exception: Medically particularly justified cases, for example in the case of severe jaw abnormalities, in which surgical corrections are also necessary.
The severity of the malocclusion is defined by five orthodontic indication groups. At least the classification in the treatment requirement level 3 of the indication groups is required.
- Treatment plan of the orthodontist
For the treatment of children and adolescents, a personal contribution of 20 percent must be paid in advance. The health insurance company reimburses the own contribution after the end of the successfully completed treatment. If several children of a family are in treatment at the same time, the own contribution is reduced to ten percent for the second and each additional child.
Costs for additional services that go beyond sufficient, appropriate and economical care or special materials are borne by the insured persons.
You can appeal against the decision of the health insurance company. If the objection is not remedied, you can file a complaint with the competent social court.
Contact your health insurance company.
Lower Saxony Ministry of Social Affairs, Health and Equality
27.11.2020
The text was automatically translated based on the German content.
10117 Berlin, Stadt
50968 Köln, Stadt
