Because orthodontics belongs to the category of cosmetic surgery, it is generally expensive and at its own expense. So medical insurance is not reimbursed.
In regular hospitals, the examination fees for oral dental examination can be reimbursed through medical insurance, and most of them need to be paid at their own expense.
When it is necessary to do orthodontic treatment, you can go to the hospital to do corresponding targeted orthodontic treatment according to the actual situation of your teeth. Through orthodontic treatment, you can restore the normal beauty of your teeth, and you also need to pay attention to the care of your teeth.
Not included in the scope of medical insurance reimbursement: At present, there are five types of medical treatment items not included in urban basic insurance treatment items, including service items, non-disease treatment items, medical treatment equipment and medical materials, and medical treatment items.
In addition to the cost of orthodontics, medical insurance does not reimburse non-disease treatment items, that is, various cosmetic plastic surgery; All expenses of various weight loss, weight gain and projects;
Prevention, project; All kinds of non-therapeutic consultation and appraisal fees; Diagnosis and treatment equipment and medical materials, that is, inspection and treatment projects carried out by large equipment such as ophthalmic excimer laser therapeutic apparatus;
All kinds of self-use, massage, procuratorial and therapeutic instruments; The price part stipulates disposable medical materials that cannot be charged separately. Remarks: Medical insurance cannot be used to reimburse orthodontics, which fully illustrates the limitations of medical insurance, but consumers can reimburse medical expenses by purchasing commercial dental insurance.
Dental insurance refers to the insurance that specifically covers dental diseases, generally including dental diseases, dental health care and dental accidents.
Dentistry is mainly incorporated into medical insurance coverage:
1, tooth filling (including basic materials and treatment fees);
2, tooth extraction;
3, the cost of treating periodontal disease, gingivitis and other dental diseases.
Items that cannot be reimbursed by medical insurance are:
1, dentures;
2. porcelain teeth;
3. Wash your teeth;
4. Orthodontics;
5, dental implants malt dental implants, orthodontics.
Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.
People's Republic of China (PRC) Basic Medical Care and Health Promotion Law
Article 59 The state implements the system of essential drugs, and selects an appropriate number of essential drugs to meet the demand for essential drugs for the prevention and treatment of diseases.
The state publishes the list of essential drugs, and adjusts the list of essential drugs according to the clinical application practice of drugs, changes in drug standards and the dynamics of newly listed drugs.
Essential drugs are given priority in the list of basic medical insurance drugs according to regulations.
The state improves the supply capacity of essential drugs, strengthens the quality supervision of essential drugs, and ensures the fair, accessible and rational use of essential drugs.
Article 60 The state shall establish and improve the system of drug evaluation and approval oriented to clinical needs, support the research and production of drugs urgently needed in clinic, drugs for children, drugs for the prevention and treatment of rare diseases and major diseases, and meet the needs of disease prevention and treatment.
Article 61 The State shall establish and improve a traceability system for the whole process of drug research and development, production, circulation and use, strengthen drug management and ensure drug quality.
Article 62 The state establishes and improves the drug price monitoring system, conducts cost price surveys, strengthens the supervision and inspection of drug prices, investigates and punishes illegal acts such as price monopoly, price fraud and unfair competition according to law, and maintains the drug price order.
The state strengthens the management and guidance of classified procurement of drugs. Bidders participating in drug procurement bidding shall not bid at a price lower than the cost, nor shall they bid by fraud, collusion or abuse of market dominance.