Orthodontic treatment for adults

If an adult has a severe jaw anomaly, SBK will cover the costs of orthodontic treatment. One important condition applies: the treatment must always include both orthodontic and jaw surgery measures. The term “severe jaw anomaly” is clearly defined for all statutory health insurers and encompasses a range of medical conditions. Whether such a condition is present is determined by an orthodontist, who will discuss the necessary orthodontic and surgical treatments with the patient.

If the requirements for combined orthodontic and jaw surgery treatment are met, your SBK covers 100% of the costs agreed upon with contracted dental providers.

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If you require orthodontic and jaw surgery treatment, your orthodontic practice will prepare a treatment plan and submit it to us for approval. This plan outlines all therapeutic measures, including the type of treatment, the expected duration, and the estimated costs. Your dental practice will discuss the course of treatment with you in advance.

Good to know: For your safety, we have complex treatments reviewed in advance by an independent second opinion. This ensures that the correct treatment method is chosen and that both cost and scope are appropriate.

If you disagree with the decision of your orthodontic practice, we can have the outcome reviewed in individual cases through a dental expert opinion. For individual support, please contact your personal SBK consultant. You can find their contact details here. For detailed information on jaw misalignments, visit the website  of the National Association of Statutory Health Insurance Dentists.

At the start of orthodontic treatment, you as the customer and we as the health insurance provider enter into a treatment agreement with the orthodontic practice that will treat you. This agreement is valid for the entire planned treatment duration. A change of practice is generally not intended during this period.

If you wish to change your orthodontic practice, please contact your personal SBK consultant. We will support you through this process. Common reasons for switching include relocation or a disrupted doctor-patient relationship. In any case, please review the private treatment contract you signed with your orthodontic practice in advance. It may include specific conditions regarding a possible change.

Your orthodontic practice may offer you additional private services - such as ceramic brackets or sealing around the brackets. These services are typically for aesthetic purposes or to increase comfort, and therefore cannot be covered by statutory health insurance.

Please make sure to have a detailed consultation with your orthodontist about the benefits and costs before agreeing to any of these extras. The success of your treatment is already ensured by the services covered by SBK.

A specific type of orthodontic treatment is the use of aligner trays. If you choose treatment with these plastic trays (such as Invisalign), the full cost must be covered by you privately.