The cost of providing orthodontic treatment for children and adolescents in Germany is covered to a large extent by the health insurance fund, if the extent of tooth malposition fulfils certain
criteria or the treatment needed satisfies grade 3, 4 or 5 of the Orthodontic Indication Groups (KIG).
However, the health insurance fund does not bill the Association of Statutory Health Insurance Physicians for the entire share of the cost. It first sends the patient an invoice covering 20% of the service costs (or 10% if there is a second child undergoing treatment) every three months. After the treatment has been completed (but not if it is terminated prematurely) the share of the costs paid by the patient is reimbursed. This means that all the invoices received must be kept and submitted with the certificate issued on completion of the treatment.
Since the money reimbursed by the health insurance fund covers only a basic service and the principle governing such services is that the relevant treatment must be adequate, appropriate and economical, the patient normally has to pay for non-contractual services, for which there is no reimbursement at the end of the treatment. The cost involved varies depending on the brackets and arches selected and on additional services not listed in the health insurance fund catalogue. Payment is made in monthly instalments. Since the amount of the instalments depends on the degree of difficulty as well as the type and extent of the treatment, no exact figure can be given here.
When discussing the treatment plan, Dr. Zellmann goes through the amount to be paid in the instalments in detail with the patient on the basis of an exact breakdown of the costs. As a general rule €36 (plus or minus €10) has to be paid in monthly instalments over a period of three years from the time a fixed brace is inserted.