Items that can be reimbursed by medical insurance are:
1, tooth filling, including basic materials and treatment costs: a method of repairing tooth defects with artificial substances. The substance used for repair is called filling material. Tooth tissue defect caused by dental caries, wedge-shaped defect, trauma, etc. Need to be repaired to restore its shape and function;
2. Tooth extraction is mainly caused by dental caries and periodontitis. With the development of dental and endodontic treatment technology, periodontitis is still a common cause of tooth extraction due to the reduction of dental caries.
3. Chronic pulpitis: it is a common kind of pulpitis in clinic. Because dental caries and other diseases are mostly chronic diseases, they have long-term and continuous stimulation to dental pulp, which can cause chronic inflammation of dental pulp;
4. Chronic periapical periodontitis: Chronic periapical periodontitis only refers to the chronic inflammatory reaction of the tissues around the root canal due to long-term infectious diseases and pathogen stimulation, which is characterized by inflammatory granulation tissue formation and alveolar bone destruction;
5. Chronic periodontitis: Chronic periodontitis is a common type of periodontitis at present, accounting for about 95% of periodontitis patients, which is caused by the long-standing gingivitis spreading to deep periodontal tissues.
Items that cannot be reimbursed by medical insurance are:
1, dentures;
2. porcelain teeth;
3. Wash your teeth;
4. Orthodontics;
5. dental implants.
Precautions for dental medical insurance:
1. Medical insurance only covers outpatient and hospitalization expenses, and tooth washing is not covered. Even if you find tooth decay when you go to the dental clinic to wash your teeth, the treatment at that time cannot be reimbursed.
2. You must go to the stomatology department of the hospital to see a dentist in order to enjoy medical insurance. Tooth extraction in general non-medical insurance designated dental clinics is not reimbursable.
3. The treatment of pulpitis and periapical periodontitis can also be reimbursed by medical insurance, and it is also required to go to a designated hospital for medical insurance.
4. When using medical insurance, you need to bring the medical insurance manual to the designated hospital for treatment. If you don't show the medical insurance manual or have no treatment details, the treatment expenses incurred will not be reimbursed.
If you want to have your teeth implanted and cleaned, you can use the balance of your medical insurance card to pay for it, although you can't reimburse it with medical insurance.
To sum up, some dental treatments belong to the category of medical insurance reimbursement.
Legal basis:
Article 2 of People's Republic of China (PRC) Social Insurance Law
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.