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Braces for your child: what the health insurer pays

Orthodontic treatment is expensive, but for children and adolescents the statutory health insurer covers the costs if the misalignment is severe enough. What matters is classification into the correct treatment group.

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The health insurer pays for orthodontic treatment of children/adolescents if there is a classification into orthodontic indication groups (KIG) 3 to 5, that is, a pronounced misalignment. For mild misalignments (KIG 1 to 2) the insurer generally does not pay.
You first pay a co-payment (usually 20%, and 10% for a second child in treatment), which the insurer reimburses to you after the treatment is successfully completed. Keep the receipts.

What you should do now

  1. 1

    1. Check the classification

    Have the KIG classification explained; from KIG 3 it is an insurer benefit.

  2. 2

    2. Collect co-payment receipts

    Keep all proof of payment for the co-payment.

  3. 3

    3. Apply for reimbursement

    After successful completion, reclaim the co-payment from the insurer.

  4. 4

    4. Object if rejected

    If you disagree with the classification/rejection, you can file an objection within one month (§ 84 SGG).

Frequently asked questions

Does the health insurer pay for my child's braces?

Yes, if the misalignment is severe enough, specifically with a classification into orthodontic indication groups (KIG) 3 to 5. For mild misalignments (KIG 1 to 2) the statutory insurer generally does not cover the costs; they are then private-pay services.

Do I get the co-payment back?

Yes. During treatment you pay a co-payment (usually 20%, and 10% for a second child treated at the same time), which the health insurer reimburses to you after successful completion. Keep the receipts and submit them at the end of treatment.

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We put together the ready-made texts and the right places to contact for you.

General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.