1, the patient must be a medical insurance insured or a family member of a medical insurance insured;
2 patients with dental diseases need treatment, and the treatment items are within the scope of medical insurance;
3. Patients need to carry valid medical insurance cards, ID cards and other documents when seeking medical treatment, and explain to doctors that they need to pay with medical insurance.
Dental medical insurance reimbursement materials:
1, medical insurance card: use a valid medical insurance card for settlement in hospitals or outpatient clinics;
2. Outpatient medical records: Outpatient medical records record the dentist's condition, treatment plan, expenses and other information, and need originals and copies;
3. Medical expenses: medical expenses for going to the dentist should be provided, including details of medical expenses, medicine expenses, examination fees, etc. The original and photocopy are required;
4. List of dental treatment items: If the dentist needs dental treatment, it is required to provide a list of dental treatment items, including treatment items, treatment costs and other information, and the original and photocopy are required;
5. Other relevant materials: such as diagnosis certificate, treatment plan, doctor's prescription, etc.
Medical insurance reimbursement conditions:
1. Confirm the insured status: before seeking medical treatment, you need to confirm that you have participated in local medical insurance, which can be confirmed by means of social security card and medical insurance certificate;
2. Medical category: Medical insurance generally only reimburses therapeutic medical behaviors, such as outpatient service, hospitalization, surgery and examination. Some cosmetic medical behaviors, such as dental beauty and plastic surgery, are usually not covered by medical insurance reimbursement;
3. Medical expenses: Medical insurance will only reimburse medical expenses that meet the requirements, such as medical expenses, medicine expenses, examination expenses, operation expenses, etc. Personal expenses, medical insurance will not be reimbursed;
4. Hospital qualification: Medical insurance will only reimburse the medical expenses of legally operated medical institutions, such as public hospitals and qualified private hospitals. Medical insurance will not be reimbursed for illegal medical institutions or clinics.
To sum up, the proportion and standard of medical insurance reimbursement vary according to different regions and policies, and the specific situation needs to be operated according to local regulations and requirements.
Legal basis:
Article 23 of People's Republic of China (PRC) Social Insurance Law
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.