According to the social insurance law of People's Republic of China (PRC), the expenses paid by the basic medical insurance fund shall meet the requirements of drug list, diagnosis and treatment items, standards of medical service facilities and emergency rescue. In terms of dental treatment, such as tooth filling, tooth extraction and treatment of periodontitis, gingivitis and other dental diseases can be reimbursed, but dental implants do not belong to this category. Nevertheless, some public hospitals or private dental institutions with designated medical insurance cooperation may allow the use of the balance of medical insurance cards to pay for expenses unrelated to dental implant materials, such as dental implants and crowns.
The scope of medical insurance reimbursement mainly includes the following aspects:
1, medical insurance drug list:
Class A drugs: drugs that are necessary for clinical treatment, widely used, with good curative effect and lower price among similar drugs. When the insured uses such drugs, they can all be included in the scope of reimbursement, and then reimbursed according to the prescribed proportion.
Class B drugs: drugs that can be used for clinical treatment and have good curative effect, and the price of similar drugs is higher than that of class A drugs. When using such drugs, the insured person needs to pay a certain proportion, and the rest is included in the scope of reimbursement, and then reimbursed according to the prescribed proportion.
Class C drugs: they are not listed in the medical insurance drug list, so all of them are not reimbursed, including many imported drugs and specific drugs.
2, diagnosis and treatment project directory:
Routine medical expenses, such as treatment expenses, examination expenses, operation expenses, etc. , can be reimbursed in proportion.
Unconventional medical expenses, such as registration fee, visiting fee, beauty treatment, physical examination, etc. All of them are not reimbursed by medical insurance.
3, medical supplies directory:
It mainly reimburses the bed fee, but does not reimburse the following medical consumables, such as dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation devices, as well as various self-use health care, massage, examination and treatment devices.
To sum up, dental implants are generally not covered by medical insurance reimbursement, but the economic burden can be reduced by other means.
Legal basis:
People's Republic of China (PRC) social insurance law
second
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.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.