Hospital dental department medical insurance can be reimbursed, but it has a certain scope of application.

The following is the scope of reimbursement and non-reimbursement by hospital dental insurance:

1. The scope of reimbursement: Generally speaking, tooth fillings (including basic materials and treatment fees), tooth extractions , the cost of treating periodontal disease, gingivitis and other dental diseases is within the scope of medical insurance reimbursement. For treatment at medical insurance designated medical institutions, you can bring your medical insurance card to reimburse part of the expenses. The specific reimbursement ratio varies according to different levels of medical institutions and regional policies.

3. Non-reimbursable scope: mainly includes dental dentures, porcelain teeth, teeth scaling, orthodontics, dental implants, etc. These are classified as dental cosmetics and are not covered by medical insurance reimbursement and need to be paid by the patient at their own expense .

The medical insurance reimbursement process for dental clinics:

1. Register for treatment.

2. Wait for confirmation from the hospital. If you meet the relevant medical insurance conditions for the dental clinic, you can fill in the notification form.

3. The patient brings his or her ID card, diagnosis and treatment notice and other information to the hospital for review and filing, collects the medical record and pays the advance fee for diagnosis and treatment.

4. After the treatment is completed, settlement will be made with relevant vouchers.

5. Finally, the unit will bring the above information to the local medical insurance business center to handle the reimbursement procedures.

6. The prerequisite for medical insurance reimbursement is that the medical insurance is within the reimbursement payment time stipulated by the local area, and the hospital for treatment must be a designated hospital or clinic stipulated by the medical insurance. For drugs that exceed the scope, generally you want to import materials. Not reimbursable. Reimbursement is only possible if the above conditions are met.

To sum up, the therapeutic medical services of the hospital’s dental department can be included in the scope of medical insurance reimbursement, but non-therapeutic oral beauty projects are usually not reimbursed.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 29

Insured Persons The part of the medical expenses that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit. The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.

Article 30

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Should be paid from the work-related injury insurance fund;< /p>

(2) Should be borne by a third party;

(3) Should be borne by the public health department;

(4) Seeking medical treatment abroad of. Medical expenses shall be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first. After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.