Cost of Orthodontic Treatment for Privately Insured Patients
Private health insurance (PKV) was a wonderful thing in the past. It offered young, healthy and well-paid individuals generous, fully comprehensive insurance at a low cost but it was simply not economically viable. Unfortunately, the good times are gone because, today, private insurance companies are checking more and more whether the cost of a particular treatment should actually be reimbursed and how much they are prepared to pay. This means that there are big differences in how the 48 private German insurance companies reimburse their members. These differences can range from great generosity on one side to rejecting every claim on the other, even it means knowingly infringing the law. So when you request a treatment plan from an orthodontist and then submit to the insurance company, it really is a question of just waiting to see what happens. With adults, the PKV will always ask for all the diagnostic reports in order to assess your claim and this is becoming more common for children as well. The assessors who work on behalf of the private insurance companies are of course not neutral but are contracted by the PKV. And this vested interest is often reflected in the actual assessments. Private insurance companies often engage in petty arguments about the size of the bill, in particular the incremental factors, rather than arguing about the actual necessity of the treatment. Unfortunately, these arguments are becoming more and more irritating for both the patients and the doctors.
In accordance with the prevailing scale of charges, private insurance companies can be billed for multiple items just like with public insurance. But these anomalies have largely been ironed out over the past few years as a result of people making private contributions to their public health insurance. So, as a result of the decreasing cover offered by private insurance companies, privately-insured people are slowly having to get used to paying a certain proportion of the costs themselves. The cost of treatment can range from €1,000 to straighten two front teeth to more than €10,000 for complicated treatment in adults.