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Source: BUS Sachsen-Anhalt (Linie6PLus)

Apply for orthodontic treatment

Description

The health insurance company covers the costs of medically necessary orthodontic corrections (KfO treatments) up to the age of 18. The decisive factor here is the start of 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 severity 3 (KIG 3), the health insurance pays the costs for children and adolescents under 18 years of age for the treatment.

Adults usually have to pay for orthodontic treatment themselves.

Exception: Medically justified cases, for example in severe jaw abnormalities, in which surgical corrections are also necessary.

Health insurance companies cover the costs of medically necessary orthodontic treatment for children and adolescents under the age of 18.

Contact your health insurance company.

The severity of tooth misalignment is defined by five orthodontic indication groups. At least the classification in the treatment requirement level 3 of the indication groups is required.

  • Orthodontist's treatment plan

In the treatment of children and adolescents, a 20 percent share must be paid in advance. The health insurance company reimburses its own share after the end of the successfully completed treatment. If several children in a family are in treatment at the same time, the proportion of their own is reduced to ten percent for the second and each additional child.

Costs for additional services that go beyond adequate, appropriate and economic care or special materials are borne by the insured.

You can appeal against the decision of the health insurance company. If the objection is not remedied, you can appeal to the competent social court.

The text was automatically translated based on the German content.

Lower Saxony Ministry of Social Affairs, Health and Gender Equality

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