How much do braces cost?

When people talk about the costs of orthodontic treatment, they generally mean the financial investment. However, in addition to the money, you also have to factor in the time and effort—that is, the inconvenience—as part of the “costs.”

The cost of orthodontic treatment generally depends on the duration of treatment, the type of braces, the complexity of the case, and the practice’s fee structure. For this reason, the orthodontist always draws up a treatment plan before beginning treatment, taking all of these factors into account.

The cost of private treatment for procedures of moderate to high complexity can range from 5,000 to 12,000 euros. The cost of private treatment for less complex procedures is lower, starting at 1,899 euros, for example.

For treatment covered by public health insurance, which takes an average of 4 years, the orthodontist receives approximately 3,000 euros from public health insurers.

When do statutory health insurance plans cover the costs?

When deciding whether to cover the costs of orthodontic treatment, statutory health insurance providers follow a system known as KIG, in accordance with Book V of the Social Code. KIG stands for “Orthodontic Indication Groups.”

These indication groups can be summarized in a table listing all types of dental and jaw malocclusions. For each malocclusion, severity levels ranging from 1 to 5 are defined. Statutory health insurance plans cover the costs only for cases with a severity level of 3 or higher.

It is important to note that this is not a table that defines the medical necessity of treatment! It simply specifies who is eligible to receive braces at the expense of the public health insurance system and who is not.

How are prices set in orthodontics?

For an orthodontic practice to break even—that is, to achieve the so-called “black zero”—it must generate an average revenue of approximately 290.00 euros per hour. Of course, the individual “basic costs” vary depending on the practice’s location and equipment, as well as many other factors.
On top of these basic costs come the laboratory and material costs for the specific type of braces requested. Each practice owner calculates individually how much their entrepreneurial risk (a practice costs on average about ½ million euros), their at least 9 years of training, and the time and effort required for each treatment, etc., are worth. The combination of all these factors then determines the total cost of your private orthodontic treatment.

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Co-payments for private insurance? Is there such a thing?

Not only with public health insurance but also with private health insurance, there are increasingly frequent restrictions on coverage designed to reduce costs for the insurers. These restrictions on coverage depend on the specific policy and are therefore individualized, unlike with public health insurance.

How does billing for orthodontic treatment work?

For billing orthodontic services, there is a type of billing code—called billing items—that is mandated by law. Every procedure, regardless of whether it

• bonding brackets,
• taking X-rays or
• which is the print name for models,

Everything must be estimated and listed using these predefined billing items before treatment begins. A distinction is made between billing items for public and private health insurance plans.

What are non-contractual services (AVLs), and why do they exist?

The coverage provided by statutory health insurance plans is limited compared to what modern orthodontics has to offer.
If you wish to tailor your treatment independently of the requirements of statutory health insurance plans, your orthodontist will bill you privately for all treatment methods that are not covered by statutory health insurance.
These are referred to as “non-contractual services,” or AVL for short.

As a patient, you can insist on treatment that is provided solely in accordance with the regulations of the statutory health insurance plans . This treatment must then be cost-effective, adequate, and appropriate as defined by the statutory health insurance plans.