Children's Braces Insurance: Optimising Costs and Closing Gaps
10 Apr 2025
11
Minutes
Katrin Straub
CEO at nextsure
A brace for children can quickly cost several thousand euros, especially if modern methods are desired. Statutory health insurers often only cover a fraction of the costs. Suitable children's brace insurance protects against unexpected expenses and ensures your child receives the best possible treatment.
The topic in brief and concise terms
Statutory health insurance funds cover the cost of braces for children only when medically necessary (KIG 3-5) and reimburse only standard services; a personal contribution of twenty percent is refunded after successful treatment.
Additional costs for modern, aesthetic, or more comfortable braces solutions (e.g., invisible braces, special brackets) often have to be privately borne and can amount to several thousand euros.
A private dental braces insurance for children can cover these additional costs as well as the costs for treatments of minor misalignments (KIG 1-2) and should be taken out well before a diagnosis is made.
Cost trap braces: What the statutory health insurance really pays
The statutory health insurance (GKV) only covers the costs for braces for children under 18 under certain conditions. [1]
The decisive factor is the classification into the orthodontic indication groups (KIG). These five severity levels define the medical necessity of a treatment. [1]
The GKV generally only provides support for KIG levels 3 to 5. [3]
Parents must first cover a personal share of twenty percent of the treatment costs. [4]
For a second child undergoing simultaneous treatment, it's ten percent. [4]
This amount is reimbursed by the insurance after successful completion of the therapy. [1]
Treatments for KIG levels 1 and 2 are often considered aesthetic and are mostly not paid for by the GKV. [8]
Understanding KIG Classification: The Key to Cost Coverage
The KIG system was introduced on the first of January 2002. It aims to objectively assess the necessity of orthodontic treatments. [8]
There are five levels that describe the severity of dental or jaw misalignments. KIG 1 are mild misalignments, KIG 5 are extremely severe. [1]
The classification is made by the orthodontist based on precise measurements.
Coverage by the statutory health insurance usually begins at KIG 3. [5]
This means: For milder misalignments (KIG 1 and 2), the costs must be borne entirely privately.
Many parents are surprised that even medically advised corrections in KIG 2 are often not covered by the insurance.
A private supplementary dental insurance can be an important financial support here.
The exact KIG classification is therefore the first step in clarifying the cost issue.
Additional Costs in View: Where Private Co-payments Lurk
Even for KIG 3 to 5, the statutory health insurance only covers the costs for “adequate, appropriate and economical” standard care. [1]
Modern and more aesthetically pleasing treatment methods often lead to considerable additional costs. These can easily exceed a thousand euros. [2]
The most common additional services include:
Discrete brackets (e.g. ceramic or plastic)
Lingual braces
Clear aligners, which can cost up to six thousand euros [3]
Shorter treatment times using special techniques
Professional dental cleanings during treatment
Retainers to stabilise the result
These additional services often significantly enhance comfort and aesthetic results.
Without a children's orthodontic insurance, parents have to bear these costs entirely themselves.
It is therefore advisable to consider securing coverage early on.
Optimal Protection: The Role of Dental Supplementary Insurance
A children's dental brace insurance fills the gap in statutory health insurance. It can cover costs for treatments in KIG 1 and 2. [1]
Additionally, it covers the additional costs for KIG 3 to 5. [1]
Policies are available from just a few euros per month. However, the premiums increase as the child gets older. [7]
Important features of a good supplemental dental insurance for children include:
Coverage of costs even for KIG 1 and 2
High reimbursement rates for additional services (ideally eighty to one hundred percent)
Coverage of preventive care and fissure sealing
Benefits for retainers
No long waiting periods or annual limits in the first few years
It is essential to take out insurance before the dentist or orthodontist diagnoses a misalignment. [1]
A supplemental dental insurance for the whole family can also be an option.
A careful review of the policy terms is crucial.
Practical Tips: Avoid Cost Traps and Secure Grants
To keep the costs of braces under control, parents should consider a few points.
First, a detailed treatment and cost plan from the orthodontist is essential.
This should clearly indicate which services are covered by the statutory health insurance and which are billed as private services.
If uncertain, seek a second opinion, especially if high additional costs are involved.
Carefully keep all invoices and the final certificate from the orthodontist.
You will need these for the reimbursement of the personal contribution from the statutory health insurance. [4]
Ensure that your child wears the braces as instructed and attends all check-up appointments, otherwise the entitlement to reimbursement may be lost. [1]
Information on the tax deductibility of medical expenses may also be relevant.
Early and comprehensive information helps to minimize the financial burden.
Expert Depth: Legal Foundations and Recent Judgments
The legal basis for the GKV's obligation to provide benefits for orthodontic treatments is found in § 29 of the Social Code Book Five (SGB V). [1]
There, the entitlement to orthodontic care for medically justified indication groups is established.
The exact guidelines, particularly the KIG classifications, are determined by the Joint Federal Committee (G-BA).
Recent judgments repeatedly confirm the GKV's benefit restrictions to what is medically necessary, in the sense of standard care.
Our expert tip: Clarify exactly which services your health insurance covers before starting treatment and which it does not.
If costs are rejected or there are ambiguities regarding the KIG classification, an appeal or an expert opinion procedure may be considered.
A correct submission of the cost estimate is crucial in this regard.
nextsure is happy to advise you on your options and support you in choosing the right coverage.
More useful links
Stiftung Warentest provides comprehensive information you should consider before visiting an orthodontist.
Federal Ministry of Health offers a detailed IGES report on orthodontics, giving deeper insights into the subject.
GKV-Spitzenverband provides information about the guidelines of the Federal Joint Committee (G-BA) on dental care.
Techniker Krankenkasse explains the conditions for cost coverage of orthodontic treatments for children.
Stiftung Warentest presents test results and comparisons of dental supplementary insurances.
Wikipedia offers a comprehensive overview of the field of orthodontics.
German Society of Orthodontics provides information and resources from the professional association for orthodontics.
FAQ
What exactly are the Orthodontic Indication Groups (KIG)?
The KIG is a five-step system (KIG 1 to 5) that assesses the severity of dental and jaw misalignments in children and adolescents. [1] The classification determines whether the statutory health insurance covers the costs of treatment (usually from KIG 3 onwards).
My health insurance covers the braces (KIG 3), so why should I still take out an insurance policy?
The statutory health insurance only covers the costs for standard treatment. If you want more modern, discreet, or comfortable solutions for your child (e.g., ceramic brackets, lingual braces), additional costs often exceeding one thousand euros may arise, which can be covered by supplementary dental insurance. [2]
What happens to the personal contribution of twenty percent in the statutory health insurance?
You pay the personal contribution of twenty percent (or ten percent for additional children being treated) to the orthodontist during the treatment. After successful completion of the treatment, this amount will be fully reimbursed to you by your statutory health insurance. [4]
Does a children's dental brace insurance also cover the cost of retainers?
Many good supplementary dental insurance policies for children also cover the costs of retainers, which are important for stabilizing the results after active braces treatment. Check the exact benefit details of your plan.
Can I take out insurance if a dental misalignment has already been diagnosed?
Insurance typically does not cover treatments that have already been diagnosed or recommended. Therefore, it is important to take out insurance before a need for treatment is known. A few policies offer immediate benefits, but these are often more expensive and come with coverage limitations.
How do I find the best children's braces insurance for my child?
Compare rates in terms of reimbursement levels for KIG 1-5, additional costs, waiting periods, and any benefit limits. Pay attention to transparent conditions. Independent advice, like that offered by nextsure, can help you find the right coverage.
