1. coverage of dental treatment by medical insurance policy
in China, coverage of dental treatment by medical insurance policy varies from region to region. Under normal circumstances, medical insurance can reimburse some dental treatment expenses, but the specific reimbursement ratio and scope need to refer to the local medical insurance policy. Generally speaking, routine dental examination, tooth extraction, tooth filling and other treatment items may be more easily covered by medical insurance, while some high-end dental cosmetic items may not be covered by medical insurance.
II. Classification and reimbursement of dental treatment items
There are many kinds of dental treatment items, including routine examination, tooth cleaning, tooth extraction, tooth filling, dental inlay and orthodontics. Among them, some basic treatment items, such as routine examination, tooth extraction and tooth filling, can usually be reimbursed by medical insurance to a certain extent. However, for some more complex or high-end dental treatment projects, such as orthodontics and dental implants, the reimbursement rate of medical insurance may be low, or even not within the scope of reimbursement.
iii. reimbursement process of dental medical insurance in outpatient clinic
If the patient's dental treatment items meet the requirements of the medical insurance policy, you can consult the doctor about related reimbursement when you see the dentist in outpatient clinic. Generally speaking, patients need to provide a valid medical insurance card and relevant identification, and fill in the relevant reimbursement application form according to the requirements of the hospital. The hospital will settle the expenses according to the patient's medical insurance policy, and submit the eligible expenses to the medical insurance department for reimbursement.
IV. Precautions
When seeing a dentist in an outpatient clinic, patients should pay attention to the following points: First, understand the local medical insurance policy and make clear which dental treatment items can be reimbursed; Secondly, choose a regular medical institution for treatment to ensure the quality and safety of treatment; Finally, properly keep the relevant medical expense invoices and reimbursement vouchers for future reimbursement applications.
To sum up:
Whether outpatient dental medical insurance can be reimbursed depends on the specific medical insurance policy and the type of dental treatment. Patients should know the local medical insurance policy, choose a regular medical institution for treatment, and properly keep relevant vouchers for reimbursement in the future. At the same time, patients can consider buying commercial medical insurance or other ways to reduce their financial burden for treatment items that are not covered by medical insurance.
Legal basis:
Article 28 of the Social Insurance Law of the People's Republic of China
stipulates:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.
Article 25 of the Medical Security Law of the People's Republic of China
stipulates:
The state establishes and improves the basic medical insurance fund payment system, and defines the scope and standards of the basic medical insurance fund payment.