Belgium Proposes Capping Children’s Braces at €792
Belgian Health Minister Frank Vandenbroucke (Vooruit) has proposed a sweeping reform to make orthodontic treatment more affordable for families, capping annual out-of-pocket costs for children’s braces at €792 starting in 2027. The plan, which would integrate orthodontic care into Belgium’s existing “maximumfactuur” (maximum billing) system, has drawn sharp criticism from orthodontists who warn it could compromise care quality and limit treatment options for young patients.
According to Het Laatste Nieuws, the proposal earmarks €14 million from the national health insurance budget (RIZIV/INAMI) to cover the additional costs. The total healthcare budget stands at approximately €6 billion, with €1.5 billion allocated annually for dental care alone.
How the Maximum Billing System Would Work
Belgium’s “maximumfactuur” (MAF) is a protective mechanism that caps annual out-of-pocket healthcare costs for families based on income. For children under 19, the standard cap is €792 per year, covering co-payments for doctors, dentists, medications, and hospital stays. Orthodontic treatment costs beyond standard co-payments were previously excluded from this cap.
Under Vandenbroucke’s proposal, the full cost of braces — including the portion currently charged above the official rate — would fall under this ceiling. As VRT NWS reports, the minister stated: “A good set of teeth should not depend on your parents’ wallet. Braces are expensive and only getting more expensive. Time to intervene.”
The Current Cost Burden on Families
A typical orthodontic treatment in Belgium costs approximately €4,500. Currently, RIZIV reimburses up to €1,150, and health insurance funds add another €1,050 to €1,500, leaving parents with an average out-of-pocket cost of roughly €2,095 — far above the official legal price of €1,210. For low-income families with increased intervention (BIM) status, the out-of-pocket cost averages €1,851.
A separate investigation by De Morgen published on June 9 revealed that top-earning orthodontists make up to €500,000 in profit, raising questions about the cost structure of orthodontic care in Belgium.
Orthodontists Push Back
Jean-Louis Hanssens, spokesperson for the Belgian Professional Association of Dutch-speaking Orthodontists (BBNO), expressed cautious but critical reactions to the plan. “Of course we welcome any initiative that benefits the patient,” Hanssens told HLN. “But we first want to see how it will be worked out.” He noted that the proposal is currently in the minister’s cabinet and has not yet been formally presented to orthodontists for consultation.
A key condition of the plan is that it applies only to “conventioned” orthodontists — those who agree to follow official tariff agreements. Currently, 43% of orthodontists are conventioned, a significant increase from previous years following national tariff agreements that introduced a maximum tariff of €4,500 for conventioned practitioners. The remaining 57% of orthodontists can still charge supplements not covered by the cap.
As Business AM notes, the reform functions as a financial safety net: once the annual €792 threshold is reached, further co-payments are reimbursed. However, this protection only applies to patients visiting conventioned orthodontists.
Implications and Challenges
The proposal raises several critical questions. With only 43% of orthodontists currently conventioned, the plan’s success depends on more practitioners joining the system. Vandenbroucke expects market pressure will drive this shift, stating: “We can do this within the existing budget. With a small effort we can make so many children happy.”
Long waiting lists for braces already exist in Belgium, and increased affordability could drive up demand, potentially worsening access issues. Hanssens acknowledged this concern but expressed optimism: “All practices are actively working to reduce waiting times. That trend will certainly continue in the coming years.”
From July 1, 2026, it will no longer be possible to charge supplements to beneficiaries of the increased intervention (BIM) status, providing additional relief for low-income families ahead of the broader 2027 implementation.
What’s Next
The proposal is part of broader negotiations on the 2027 healthcare budget. Orthodontists have yet to receive a formal invitation from the minister’s cabinet for consultation, raising questions about the readiness of the plan. If implemented, this could be a first step toward broader reform of dental and orthodontic care pricing in Belgium, potentially leading to a two-tier system where wealthier families bypass the cap by choosing non-conventioned orthodontists.
The coming months will reveal whether the necessary political consensus can be reached — and whether enough orthodontists will join the convention system to make the cap meaningful for the families it aims to protect.