Whether the cost of dental care can be reimbursed by medical insurance mainly depends on what kind of cost it is:
1, treatment cost
According to the corresponding regulations of medical insurance, the cost of dental treatment, if it is therapeutic, can be reimbursed, such as the removal of impacted teeth and the treatment of periodontal disease, which can be reimbursed through medical insurance.
2. Beauty expenses
Such as expenses related to dentures or medical cosmetic repairs, such as orthodontics, porcelain restoration, tooth whitening, etc. , does not meet the conditions for medical insurance reimbursement.
In addition, only dentists in designated medical institutions can enjoy medical insurance reimbursement concessions, and in general non-medical insurance designated dental clinics, even treatment expenses can not enjoy medical insurance reimbursement.
The reimbursement process of dental insurance
1, go to the hospital dental clinic first.
2. Wait for the hospital to confirm that you can fill in the notice if you meet the relevant medical insurance conditions for dental clinics.
3. Patients with ID cards, medical notices and other materials to the hospital for review and filing, and receive medical records for diagnosis and treatment in advance.
4. After the processing is completed, the settlement shall be made with relevant documents.
5. Finally, the unit shall go to the local medical insurance business processing center for reimbursement with the above information.
As can be seen from the above, gingivitis, gingivitis, tooth extraction and other expenses within the scope of medical insurance can be reimbursed. However, if porcelain teeth, orthodontics, dental implants, etc. It belongs to the scope of cosmetic medical treatment and cannot be reimbursed.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.