Benefits for Children and Adolescents

Children and adolescents are entitled to several health benefits beyond adults' entitlements. For children and adolescents under 18, statutory health insurance funds pay for preventive checkups, vaccinations, orthodontic treatment, dental checkups, and aids such as eyeglasses.

Preventive medical checkups for children and adolescents
Statutory health insurance funds pay for preventive checkups for children and adolescents to detect developmental delays, health problems, and diseases. Parents do not have to make any additional payments. The examinations focus on physical and mental development, and vaccination status between a child's birth and their 6th birthday. An "adolescent examination" is conducted between the child's 12th and 14th birthdays to examine the adolescent's developmental and emotional states.

Vaccinations for children
Statutory health insurance funds pay for eleven vaccinations to be carried out on predetermined dates. These include vaccinations against diphtheria, tetanus, polio, hepatitis B, and whooping cough. For young women, vaccination against cervical cancer is also covered by statutory health insurance. Statutory health insurance also pays for the necessary booster vaccinations.

Orthodontic treatment
If there is a medically justified indication, orthodontic treatment for children and adolescents under 18 is covered by statutory health insurance. This means that biting, chewing, speaking, or breathing must be significantly impaired or threatened by a malocclusion. If the impairment is minor or the treatment is cosmetic, statutory health insurance does not contribute to the costs.

Dental treatments
Statutory health insurance pays for children between the ages of 3 and 6 to be examined for dental, oral, and maxillofacial diseases. Children between 6  and 18 years are entitled to two yearly examinations. From the twelfth year, it is essential to get examination certificates, which are then recorded in a "bonus booklet" and guarantee higher subsidies for dental prostheses. Dental services include fissure sealants, fluoridation, and oral hygiene consultations. Services such as professional teeth cleaning are often covered by statutory health insurance as additional benefits but are not part of the legally mandated benefits catalog.

Entitlement to eyeglasses for children and adolescents
Children and adolescents are entitled to eyeglasses until the age of 18. From the age of 14, children are entitled to new eyeglasses only if their prescription changes by more than 0.5 diopters. Children of preschool age and children under 14 with visual impairment greater than plus or minus 5 diopters are entitled to plastic lenses. If plastic lenses are necessary for participating in school sports, statutory health insurance will also cover the costs.

If the child becomes ill – health insurance benefits
Statutory health insurance pays child sick pay when children under 12 years of age are sick if a doctor deems it necessary for the child to be looked after and consequently the parent is unable to work. A parent is entitled to child sick pay for a maximum of 10 work days per child per year up to 25 work days (for more than 2 children). Higher entitlements apply for single parents. Child sick pay is paid for children with disabilities even after they turn 12.