I coverage of dental treatment by medical insurance
In China, the coverage of dental treatment by medical insurance policy varies from region to region. Under normal circumstances, medical insurance can reimburse some dental treatment expenses, but the specific reimbursement ratio and scope need to refer to the local medical insurance policy. Generally speaking, routine dental examination, tooth extraction, tooth filling and other treatment items may be more easily covered by medical insurance, while some high-end dental cosmetic items may not be covered by medical insurance.
Second, the classification and reimbursement of dental treatment projects
There are many kinds of dental treatment, including routine examination, tooth washing, tooth extraction, tooth filling, tooth filling, orthodontics and so on. Among them, some basic treatment items, such as routine examination, tooth extraction and tooth filling, can usually be reimbursed by medical insurance to a certain extent. For some complex or high-end dental treatment projects, such as orthodontics and dental implants, the reimbursement rate of medical insurance may be low, or even beyond the scope of reimbursement.
Third, the outpatient clinic to see the dental medical insurance reimbursement process
If the patient's dental treatment program meets the requirements of the medical insurance policy, then you can consult the doctor about reimbursement when you see the dentist in the outpatient clinic. Generally speaking, patients need to provide a valid medical insurance card and relevant identification, and fill in the relevant reimbursement application form according to the requirements of the hospital. The hospital will settle the expenses according to the patient's medical insurance policy and submit the eligible expenses to the medical insurance department for reimbursement.
Fourth, matters needing attention
Patients should pay attention to the following points when they see a dentist in the outpatient clinic: First, understand the local medical insurance policy and make clear which dental treatment items can be reimbursed; Secondly, choose regular medical institutions for treatment to ensure the quality and safety of treatment; Finally, properly keep the relevant medical expense invoices and reimbursement vouchers for future reimbursement.
To sum up:
Whether outpatient dental medical insurance can be reimbursed depends on the specific medical insurance policy and the type of dental treatment project. Patients should understand the local medical insurance policy, choose a regular medical institution for treatment, and properly keep relevant vouchers for future reimbursement. At the same time, for the treatment items not covered by medical insurance, patients can consider purchasing commercial medical insurance or other ways to reduce the economic burden.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
People's Republic of China (PRC) Medical Security Law
Article 25 provides that:
The state establishes and perfects the basic medical insurance fund payment system, and defines the scope and standard of basic medical insurance fund payment.