In China, dentistry has very strict reimbursement regulations. If it is a therapeutic dental treatment, it is within the scope of medical insurance reimbursement.
What has been included in the scope of medical insurance is mainly the cost of tooth filling (basic materials and treatment fees), tooth extraction, periodontal disease treatment, gingivitis and root canal treatment.
Like the common wisdom tooth extraction, it belongs to the scope of medical insurance card reimbursement and can be paid by medical insurance fund.
Non-reimbursable scope
If it is in the field of tooth restoration and whitening, such as tooth inlay, porcelain restoration, orthodontics, tooth implantation, tooth whitening and so on. In China's medical field, it is listed as a medical beauty repair project and can only be reimbursed by medical insurance at its own expense.
For example, the relatively high cost of dental implants is mainly the cost of materials, such as porcelain teeth and dental implants. These expenses are usually approved by the price department and belong to special service expenses, which cannot be reimbursed by medical insurance.
In addition, the medical expenses incurred by the dental clinic examination and treatment are paid by the social security card personal account. If the patient is admitted to hospital due to illness and meets the hospitalization standard, other expenses can be settled according to the provisions of medical insurance, except that the denture (denture) expenses cannot be paid by the medical insurance pooling fund.
Proportion of reimbursement for medical insurance and dental care
Different from other diseases, medical insurance has a high proportion of self-expense, and the general reimbursement rate is about 50%.
It should be noted here that not all dentists can be reimbursed by medical insurance, but they must be dental hospitals designated by medical insurance or hospitals with dental qualifications, but they must be hospitals designated by medical insurance to be reimbursed.
Here we take Beijing as an example: