Your Kid's Orthodontist Mentioned 'KIG 3': Here's Why That Number Decides Everything
Before your statutory health insurance (GKV) will pay a cent toward your child's braces, an orthodontist has to assign a KIG score, a severity rating on a 1-to-5 scale for how medically significant the misalignment actually is. GKV only covers KIG 3, 4, or 5, grades 1 and 2 are considered cosmetic rather than medically necessary, and you'd pay for those entirely yourself. If your child qualifies at KIG 3 or higher, and is under 18, the insurance covers the treatment, but not entirely for free: you pay 20 percent of the cost yourself upfront (10 percent if you have more than one child in treatment at the same time), and you get that share refunded once treatment is successfully completed. One step can't be skipped: your orthodontist has to submit a treatment plan and get it approved by your Krankenkasse before starting, not after. Past 18, the rules tighten sharply, adults only get coverage for severe cases requiring combined jaw surgery and orthodontic treatment together.
The Official Rule
Before German statutory health insurance covers any part of your child’s orthodontic treatment, an orthodontist assigns a KIG score, short for Kieferorthopädische Indikationsgruppe, orthodontic indication group, a severity classification on a scale from 1 to 5 that measures how medically significant the misalignment actually is, not how it looks.
This score is the single gatekeeping factor for coverage, and the cutoff is sharp. Statutory health insurance (GKV) only covers treatment classified at KIG level 3, 4, or 5. Levels 1 and 2 are treated as not medically urgent, essentially cosmetic from the insurance’s perspective, and if that’s where your child lands, you’d be paying for any treatment entirely out of your own pocket, insurance simply doesn’t participate at that level.
| KIG level | GKV coverage |
|---|---|
| 1-2 | None, considered cosmetic, fully self-pay |
| 3-5 | Covered, with a 20% upfront co-payment (10% with multiple children) |
If your child does qualify at KIG 3 or above, and is under 18, coverage kicks in, but it’s not entirely free upfront. You pay 20 percent of the treatment cost yourself as an Eigenanteil, or just 10 percent if you have more than one child undergoing orthodontic treatment at the same time. That share isn’t gone for good, though: once treatment is successfully completed, your upfront payment is refunded to you.
One procedural step genuinely can’t be skipped or done retroactively: insurance approval has to come before treatment starts. Your orthodontist submits a treatment plan to your Krankenkasse, and it has to be approved before the first active treatment session, not applied for afterward as a formality. Starting treatment first and seeking approval later risks the insurance simply declining to cover costs already incurred.
Turning 18 changes the picture sharply. Past that age, GKV coverage narrows to only the most severe cases, specifically jaw misalignments serious enough to require combined orthodontic and surgical treatment together, ordinary adult orthodontic correction, even genuinely needed correction, generally isn’t covered the way it is for a minor.
What Real People Say
Parents navigating this describe the KIG score itself as the detail worth asking about explicitly and early, since it’s the number that actually determines whether you’re looking at a largely insurance-covered treatment path or a fully self-funded one, and it’s not always volunteered clearly without asking.
The refund timing on the upfront co-payment comes up as a point worth clarifying directly with your specific Krankenkasse before treatment begins, since the exact process and timing for getting that share back can vary enough between insurers that it’s better confirmed upfront than assumed.
Step by Step
- Ask your orthodontist directly what KIG level they’re assigning your child, don’t assume it, get the actual number.
- If your child is KIG 3 or above, confirm your orthodontist submits the treatment plan to your Krankenkasse for approval before treatment starts.
- Budget for the upfront co-payment, 20 percent of treatment cost, or 10 percent if you have multiple children in treatment simultaneously.
- Confirm the refund process for that co-payment with your Krankenkasse ahead of time, so you know what to expect once treatment is successfully completed.
- If your child is KIG 1 or 2 and you still want treatment, check whether you have (or want to get) supplemental dental insurance that covers cosmetic-level orthodontics, since statutory insurance won’t.
Compliance Note
This page explains the general KIG classification system and statutory insurance coverage rules for orthodontic treatment in Germany, but individual assessments, Krankenkasse practices, and exact costs vary by case. For your child’s specific situation, confirm directly with your orthodontist and Krankenkasse.
FAQ & Common Pitfalls
Our orthodontist says our child is KIG 2. Does that mean no treatment is available at all?
It means statutory insurance won't cover it, not that treatment itself is unavailable. KIG 1 and 2 are classified as not medically urgent from the GKV's perspective, so treatment at that level is considered elective or cosmetic, and you'd need to pay for it entirely yourself if you choose to proceed, or check whether private supplemental dental insurance (Zahnzusatzversicherung) you already hold covers KIG 1-2 cases, some policies specifically do.
How does the refund actually work? Do we get our 20 percent back automatically?
The 20 percent (or 10 percent with multiple children in simultaneous treatment) is your upfront share, and it's refunded to you after treatment is successfully completed, not automatically the moment you pay it. This is a real incentive built into the system: it rewards seeing treatment through to completion rather than stopping partway, and it's worth confirming the specific refund process with your Krankenkasse before treatment begins so there are no surprises later.
Can we just start treatment and sort out the KIG paperwork with our insurance afterward?
No, and this is a genuinely important sequencing detail. Your orthodontist has to submit a treatment plan and get it approved by your Krankenkasse before treatment starts, not retroactively. Starting first and seeking approval afterward risks the insurance declining to cover costs already incurred, so confirm the approval is actually in hand before the first appointment that begins active treatment.