How useful is a dental insurance for children?
Many parents wonder whether you should also take out dental insurance for your children – for example, to protect yourself against high orthodontic costs. We show the advantages and disadvantages and explain whether and when it is worth taking out dental insurance for children.
A supplementary dental insurance for children is worthwhile?
Supplementary dental insurance for children makes sense especially when it comes to paying for braces. All other areas of supplementary insurance, such as tooth preservation or dentures, are rarely used in children and therefore involve a comparatively low financial risk.
Finance the braces for the child with supplementary dental insurance
According to the Barmer GEK, more than half of the children and adolescents of a year are wearing braces. The cost of orthodontic treatment is quickly in the thousands. It can therefore make sense for parents to take out additional dental insurance for children in good time, which covers the high costs. However, there are some restrictions and conditions that we want to explain to you below.
When does the statutory health insurance for orthodontics pay?
For children, statutory health insurance covers the costs of braces and orthodontic treatments as part of regular care. The following requirements apply: The treatment is
- medically necessary,
- it begins before the patient’s 18th birthday
- and is successfully completed.
Find the best dental supplement insurance and learn what to look for when choosing. How to get the cheapest offer in 5 steps.
Classification in orthodontic indication groups (KIG) – when does the health insurance cover the treatment costs?
The orthodontist determines whether a brace is medically necessary based on the severity of the misaligned tooth or jaw. He diagnoses one of the 5 orthodontic indication groups (KIG).
|Orthodontic indication group (KIG)||Expression of the tooth or jaw misalignment||GKV pays for the treatment?|
|KIG 1||Very slight misalignment such as open / deep bite or narrow teeth||No|
|KIG 2||Slight misalignment, such as a cross bite or significant tooth crowding||No|
|KIG 3||Medium malposition such as double-sided cross bite, strong deep bite or a clear lack of space||Yes|
|KIG 4||Severe misalignment such as the number of teeth, breakthrough disorders or clear side bite of the rows of teeth||Yes|
|KIG 5||Very severe deformity such as cleft lip and palate, breakthrough disorders or congenital open bite with a clear distance between the tooth edges||Yes|
Only from KIG 3 does the statutory health insurance cover the costs for orthodontic treatment. In the case of less serious malpositions (KIG 1 and 2), you have to pay for your child’s orthodontic treatment entirely yourself. In this case, additional dental insurance for children makes sense.
How to get your own share back to braces
For treatments in KIG 3 to 5, the health insurance company will initially only cover 80% of the costs incurred. The parents must advance the remaining 20% themselves. This contribution will only be reimbursed by the health insurance company if the treatment has been successfully completed.
Orthodontic treatment usually takes several years. The success of the treatment therefore depends largely on the stamina of the children (and parents). A successful result can only be expected if the braces are worn as recommended by the doctor and you adhere to the check-up appointments. Therefore, the health insurance companies pay the remaining 20% retrospectively as an incentive.
Dental supplementary insurance for children extends their own contribution
Your advantage with a supplementary dental insurance for children: Many providers extend the 20% own contribution. For parents whose child is treated in the KIG 3 to 5, this means that you will not incur any costs in orthodontic treatment. As soon as the treatment has been successfully completed and the statutory health insurance company has reimbursed its own share, pass this amount on to your dental insurance for children.
With supplementary dental insurance: children benefit from free special benefits
In the event of medical necessity and treatment discipline, the statutory health insurance company pays the entire cost of braces. Does private dental insurance for children make any sense at all? It depends on your needs: If you want the best possible, fastest and painless dental treatment for your child, you can benefit from the benefits of an additional dental insurance for children. The reason: The statutory health insurance only pays for braces as part of regular care. However, orthodontists almost always offer special services that are intended to make treatment faster and more effective. These "private medical additional costs" are not borne by the health insurance companies and must be paid by the parents themselves without appropriate dental insurance.
Special services include:
- internal and transparent braces
- Sealing of the teeth, which are more at risk of tooth decay due to the brackets
- Mini brackets for shorter treatment times and easier cleaning of the teeth
- Tooth stabilizers, so-called retainers for long-term stabilization of treatment success
How much does braces cost and how much is my own contribution??
The cost of braces and your own contribution largely depend on the classification in the orthodontic indication groups (KIGs).
KIG 1-2: In the case of minor tooth or jaw misalignments, the statutory health insurance companies do not pay at all and the parents have to pay the full amount of the treatment. As a guideline, € 2,500 to € 7,000 apply. In view of these high costs, it can make sense to take out additional dental insurance for children. However, it is up to you, the parents, to weigh up how necessary you rate orthodontic treatment. The dentists often argue for aesthetic reasons or point out possible subsequent problems in the event of non-correction. However, it is more of a cosmetic decision, there is no acute medical need for braces for your child in these indication groups.
KIG 3-5: The own contribution for the braces is lower in KIG 3 to 5, because the health insurance fund basically participates in the treatment. When choosing special services, you must expect a contribution of between € 500 and € 2,500. Here, too, the parents must decide for themselves how necessary you consider these special services to be during the treatment.
The personal contribution to orthodontic treatment must be recorded in the so-called additional cost agreement. Ask the doctor exactly what services go beyond the health insurance benefits and also check whether they are actually necessary. Orthodontists often advise more expensive, modern treatments. Her argument: the treatment will be easier, more promising and less painful for the child. This is often a dilemma for parents: On the one hand, you want to save your child from unnecessary pain and lengthy treatment. On the other hand, you ask yourself whether the advised special service is really necessary.
We recommend that you get a second opinion. Your health insurance company, the dentists’ association or consumer centers advise on the subject of dental supplementary insurance for children. A second opinion will help you make a decision for or against the advised special services.
Conclusion: Does dental supplement insurance make sense for children?
Ultimately, the decision for or against an additional dental insurance for children remains a matter of discretion. When it comes to correcting a diagnosed moderate to severe jaw or tooth malposition (KIG 3 to 5), the health insurance benefits are sufficient in most cases. The health insurers do not pay for everything that is aesthetically and medically possible, but you can also achieve your goals with the services of regular care. According to the Waizmann table, a classification in KIG 3 to 5 affects 80 to 85% of families statistically. Even if you choose many special services for your child during treatment, parents rarely pay more than € 2,500.
The situation is different for the 15 to 20% of parents whose children are classified in KIG 1 to 2. In their children, the tooth or jaw misalignment is not so serious that health insurance treatment is approved. If the parents choose treatment anyway, the cost of orthodontic treatment can quickly amount to thousands of euros. In this case, taking out additional dental insurance for children makes sense.
The problem with the matter: As soon as the orthodontist has been classified in a KIG, it is too late to take out additional dental insurance for your child with services in the field of orthodontics. The actual orthodontic treatment usually only begins between 8 and 13 years, but as soon as a diagnosis is made, the benefit is excluded from the dental insurance.
When should I take out additional dental insurance for children??
If you choose to have dental insurance for your child, you must not miss the time to take out the insurance. For children, this is already between 3 and 4 years. That may seem early, but it makes sense: at 3 years old, the baby teeth are completely developed, but orthodontic treatments are not yet foreseeable.
With insurance taken out so early, you avoid exclusions and receive full insurance coverage for your child. At the age of 5 it can be too late, because the tooth change may already have started and the dentist will note the tooth or jaw misalignment in the treatment file. One note alone is enough to exclude the benefit from dental supplement insurance for children.
Another reason for early conclusion of dental supplementary insurance for children is the benefit restrictions in the first contract years. If, for example, a policy is only concluded at the age of 8 and the diagnosis of braces is made at the age of 9, it may be that the dental insurance does not or only partially covers the costs. The reason: Many dental supplements for children only pay in full after 5 years of insurance.
How can I compare dental insurance for children?
Additional dental insurance for children must offer different benefits than additional dental insurance for adults. Therefore, you should take out a special children’s dental supplement insurance or make sure that the dental insurance only includes the services that are really important for children. Otherwise you pay more than necessary. Use the form above to request a non-binding, free insurance comparison. You should pay attention to the following criteria when making a comparison.
What benefits should dental insurance offer for children??
Orthodontic services come first. However, services in the field of dental treatment and prophylaxis also play a role when comparing dental supplementary insurance for children.
Very cheap insurance, which is available for just a few euros per month, offers only limited and often superfluous benefits such as: B. dentures. Of course, dentures can also be necessary for children in individual cases, for example if a tooth was knocked out in a sports accident. However, these are isolated cases. As a rule, dentures are very rare in children.
In the following you can read the scope of benefits that dental supplementary insurance for children should include in the various treatment areas.
Make sure that the dental supplement insurance for children covers all KIG levels. The tariff should ideally pay for diagnosed KIG 1 to 2 without a sum limit. At least € 3,000 should be covered. For treatments in KIG 3-5, the additional insurance for special services should cover at least € 1,000, better would be € 1,500. You should also make sure that the benefit limit is not too low in the first few years. Especially if your child is older than 6 years. Then a timely start of treatment is likely and a limitation of benefits would be annoying in the event of damage.
The fissure seal, i.e. the sealing of grooves and depressions on the teeth to protect the penetration of bacteria, should also be covered by the dental supplement insurance for children. In the area of prophylaxis, you should make sure that tooth cleaning is subsidized or taken over entirely. Especially during treatment with fixed braces, the teeth are often difficult to access and difficult to clean. Professional teeth cleaning maintains health and strengthens children’s dental health awareness.
Tooth fillings are not uncommon in children. The regular care provided by the statutory health insurers only provides amalgam fillings. Additional dental insurance for children should reimburse 80-100% of the cost of high-quality plastic fillings.
Root and periodontal treatments in children and adolescents are rare, but if you already choose to have dental insurance for children, your tariff should also cover these benefits. Ideally, dental insurance will reimburse 100% of the cost of root canal and periodontal treatments.
Dentures can also play a role in the milk dentition, because if there are no dentures, chewing or speaking difficulties may arise. The statutory health insurance companies pay a fixed subsidy of 50-65% for regular care. Everything else must be paid by the parents themselves. Supplementary dental insurance for children should fully cover the additional costs of dentures. Keep in mind that children between 6-18 years, unlike adults, have to go to the dentist twice a year to receive the maximum 65% subsidy from the health insurance company. Check-ups at the dentist must be documented in the bonus booklet.
What does dental supplement insurance cost for children?
Good supplementary dental insurance for children that fully meet the above criteria is between € 9 and € 15 per month. With cheaper tariffs, you usually have to expect performance restrictions. We would advise against tariffs for 3-5 € per month. These policies usually hide only weak dental prosthesis services, which your child will only use very unlikely.
Can the dental supplementary insurance for children be refinanced through the use of pension benefits??
Yes, that’s mathematically possible. Modern supplementary dental insurance reimburses children up to 100% and even if the statutory health insurance does not pay anything.
|power||costs||Proportion of statutory health insurance||Share of private dental insurance||Annual premium private dental insurance|
|Fissure sealing of the 8 premolars||€ 320||0 €||€ 320||€ 108-180|
The calculation example shows: Fissure sealing of the 8 front molars (premolars) can cost up to € 320. The statutory health insurers do not take any of this. A dental insurance for children, on the other hand, which pays 100% in the area of tooth preservation, pays the costs completely. The treatment costs for the policy are therefore refinanced for 1-2 years solely through this treatment.
The 5 most important questions about dental supplement insurance for children
Is it still possible to take out additional dental insurance for children after medically diagnosed tooth or jaw misalignment?
If a doctor has made a corresponding diagnosis, the insured event has already occurred and, unfortunately, protection is no longer possible. Now you can only choose a dental supplement tariff that excludes orthodontics from the outset. The necessity of such tariffs is questionable, however, because orthodontic treatment in children is a financial risk.
There are dental supplements for children without waiting?
Yes, there are tariffs that do not have to wait. However, this criterion should not play any role, especially when choosing dental insurance for children. Misaligned teeth or jaws that are diagnosed before the contract is concluded are excluded from insurance cover. If your child has not been diagnosed before the contract is signed and orthodontic treatment is included, it is extremely unlikely that orthodontic treatment will be advised a few months after the contract is signed. As a rule, there are several years between the conclusion of the contract and the diagnosis of braces. A waiting period of 8-12 months would not be a problem. So instead of waiting, you should put your main focus on the total benefits of dental supplement insurance.
When should I cancel the dental supplement insurance for children??
The dental supplementary insurance for children should be checked and, if necessary, canceled from the age of 21 at the latest. Orthodontic services hardly play a role for adults and have a comparatively expensive impact on the contributions. The focus of benefits should be with a dental supplement insurance for adults on high reimbursements for dentures. Check whether the same insurer with which you have taken out the dental supplement insurance tariff for your child offers good tariffs for adults and switch internally. This way you avoid a health check for your child and benefit from cheaper premiums.
If you are over 18 years of age at the start of treatment, you have to look after yourself. For adults, the statutory health insurance companies only cover the cost of braces in exceptional cases. Only if there are severe jaw anomalies that require additional jaw surgery treatment will part of the costs be covered. Otherwise, the chances of assumption of costs are poor.
Take out additional dental insurance for the baby?
We do not consider it sensible to take out additional dental insurance for children in infancy. You would pay tariffs free of charge for 5 to 6 years without receiving any benefits. The argument of cost savings due to long membership of the insurance company is also not worthwhile, since the provision for old age does not come into play with such a long term. In this case, it is better to save even for the dental treatment of the child.
Take out dental insurance for children or save yourself?
Saving yourself is an alternative to dental supplement insurance for children. If you save regularly for your child, you can offset the financial risk of orthodontic treatment.
|After 1 month||After 1 year||After 15 years||After 18 years|
|Saved money||€ 15||€ 180||€ 2,700||€ 3,240|
For example, anyone who invests € 15 a month in a call money account from birth will generate an amount of € 3,240 up to their 18th birthday. This amount would be sufficient to finance numerous special services at KIG 3-5. With a diagnosis in KIG 1-2, you could intercept at least a part of the treatment with the savings and thus minimize the costs of a braces treatment.
The big advantage of saving yourself: In contrast to the dental supplement insurance for children, the saved money is at your free disposal. So if no expensive orthodontic treatment is necessary, you can use the money in other ways, e.g. B. as start-up capital for training or studies.
If your child is between 6 and 17 years old, they are entitled to free individual prophylaxis at the dentist twice a year. The statutory health insurance companies pay for the fluoridation of the teeth, an individual oral hygiene instruction and the fissure sealing of the molars. You should definitely take advantage of this pension benefit.
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