National and private health insurance companies usually cover the cost of an orthodontic consultation appointment. This individual appointment comprises a medical examination to determine whether treatment is necessary and which further diagnostic steps should be taken.
You will be provided with general information about orthodontic treatment options. In a detailed consultation appointment, we work together with you to develop a treatment plan and show you current treatment options.
The commencement and duration of treatment as well as any potential costs incurred will be discussed with you. Should treatment be necessary, we will make an appointment with you to create your clinical record. Children and adolescents should be accompanied by a parent.
Please bring the following documents with you:
- Insurance card
- X-rays and other medical records, if available
- The medical history form we sent, completed
This involves assessing the patient's current situation.
The following records are prepared:
- A thorough clinical examination, in which not only the teeth and jaws, but also the mucous membranes, head and body posture are examined
- X-rays in order to assess the teeth, jaws, head and growth
- Impressions and a mould to produce models of the jaw and document the original situation
- Photographs of the face and teeth.
Treatment plan appointment
We conduct a thorough assessment and present you with our findings.
The following will be discussed:
- Treatment alternatives
- Advantages and disadvantages
We summarise this information in an individual treatment plan for you. The treatment plan contains an outline of the entire therapeutic treatment and must be submitted to your health insurance company to clarify any entitlement to help with costs by the respective health insurance company.
Should the health insurance company assume the entire costs for treatment, the patient must first pay 20% of the costs up front. This co-payment will be refunded after treatment has been successfully completed. Privately insured patients receive a cost estimate according to the German dental fee bands (GOZ) which can be submitted to the private health insurance to claim a refund.
After your insurance company has approved the treatment plan, we will agree the dates with you to begin treatment.
Active treatment phase
The active treatment begins with the first appliance. Depending on the apparatus, the appointment intervals are 4-12 weeks. During these appointments, the apparatuses are checked, adjusted or changed. Showing up to these appointments is extremely crucial for a successful course of treatment.
After the active orthodontic treatment comes the stabilisation phase, also known as retention, to correct tooth positions. This ensures the expected treatment result and prevents the teeth from wandering back to their original position and includes different options that we discuss with you in due time. The intervals between the follow-up appointments during this phase are 8-12 weeks. Good compliance is very crucial to the treatment's success during this phase.
During the final consultation phase the treatment is officially declared completed. The course of treatment up to this point is shown and a final certificate is issued. This means for those insured by a national insurance company that the previously paid co-payment will be refunded by the patient's insurance company.
Depending on the situation, it is recommended to continue wearing the retainer.
How long does an orthodontic treatment last?
Since orthodontic treatment is always an elective procedure for which the patient decides on his/her own after extensive consultation with the orthodontist, we attach great importance to achieving the shortest possible treatment times for our patients.
We make a distinction in treatment between an active phase during which the teeth are moved, and a subsequent passive phase (retention phase or stabilisation phase), in which the teeth are held and stabilised in their new positions.
The duration of active treatment depends on the aim of the treatment: very mild malocclusions can often be corrected within a few months whereas comprehensive active treatment usually lasts two to three years and in rare cases even longer.
The length of the retention period also varies greatly. However, long-lasting retention has been proven by using a fixed retainer, a thin wire that is glued to the back surface of the front teeth. For this reason, we recommend a retainer after each treatment so that you can enjoy your straight teeth even longer.
Patients insured with a national health insurance company under 18 years of age
Since 2001, the services offered by the national health insurance companies have been significantly cut. The German Index of Orthodontic Treatment Need (KIG) categorise malocclusions depending on the severity into 5 grades.
For "mild" malocclusions which fall under KIG grades 1 and 2, the treatment is not covered by health insurance. This does not mean that treatment is not needed in this case. In any case you should have a consultation appointment about the advantages and disadvantages of treatment.
For KIG grades 3 to 5, the national insurance company covers 80% of the cost of treatment which are part of the general dental services agreements in Germany. The remaining 20% of the treatment costs are initially borne by the patients themselves. However, these are refunded by the health insurance company after documentation regarding successful completion of treatment is provided.
Upon successful completion of the treatment and compliance with the stabilisation phase, a final certificate is issued. The previously paid co-payment is then refunded by the health insurance company.
Certain services, such as ceramic brackets, special materials, TMJ analyses and hygienic measures, for example are not covered by the national health insurance companies.
Invoices are sent every three months and include the 20% co-payment. The amount depends on the services provided since the last invoice.
Nationally insured patients over 18 years
Orthodontic treatment is only covered by health insurance, if a combined orthodontic-oral surgeon treatment pursuant to German Social Law SGB V, §28, Abs. 2 is necessary.
The health insurance company covers 80% of the cost of treatment which is part of the general dental services agreements. The remaining 20% of the treatment costs are initially borne by the patients themselves. However, these are refunded by the health insurance company after documentation on successful completion of treatment is provided.
Upon successful completion of the treatment and compliance with the stabilisation phase, a final certificate is issued. The previously paid co-payment is then refunded by the health insurance company. This means, however, that an appliance must be worn at night for a specified period.
Certain services, such as ceramic brackets, special materials, TMJ analyses and hygienic measures, for example, are not covered by the national health insurance companies. Invoices are sent every three months and include the 20% co-payment. The amount depends on the services provided since the last invoice.
Privately insured patients
Entitlement for privately insured patients depends on the respective insurance contract. The entire cost of treatment is generally covered. Individual treatment alternatives will be offered and agreed with the patient and his/her parent(s) for any necessary treatment measures which exceed normal treatment. All treatment costs are invoiced according to the statutory German dental fee bands (GOZ=Gebührenordnung für Zahnärzte).
Eligibility for help with costs
Patients who are eligible for help with costs often ask which costs are covered by your responsible centre. There is unfortunately no clear answer to this question. This often leads to discussions and considerable administrative effort. In the orthodontic field, the scope of services covered has approached that of the national health insurance, with only minor differences still in existence. The fees are based on the German dental fee bands (GOZ=Gebührenordnung für Zahnärzte) However "billable" does not always mean "eligible".
Please speak with us about this issue in the practice, and we will be more than happy to explain it to you.
Financing and paying by instalments
We work with the ABZeg billing firm. This allows you to flexibly and efficiently pay your treatment costs in instalments. Just ask us about the patient information leaflet on paying by instalments.
The ABZeg also assists you in making legitimate claims against your insurance company or other paying authorities.
What if the insurance company does not cover the treatment costs?
In this case, the treatment costs must be borne by the patient. The costs depend on the grade of difficulty and the appliances used for treatment. The exact amount can only be estimated after a personal examination. A payment plan is also possible upon request.
Can I take out supplementary private insurance?
Supplementary private insurance is possible in any case. However, you should pay attention to the individual insurance conditions, because often there is a limit to the cost of orthodontic treatment covered. In addition, the need for orthodontic treatment should not have been previously determined before signing the insurance contract. After taking out the insurance, a certain amount of time must elapse before beginning the treatment. This period varies depending on the insurance.
The cost of supplementary private insurance is graded according to the age of the children. A good overview, for example, can be found at www.hanswaizmann.de.