Proportion of dental reimbursement for medical insurance in Guangzhou

The proportion of dental reimbursement for medical insurance in Guangzhou is as follows:

1, which belongs to the payment scope of medical insurance fund, and the limit is 1000 yuan/pill; Dental implant, dental implant restoration, tooth whitening and other medical projects;

2. Dental filling materials (such as glass ions and resins) and root canal therapy. , which belongs to the scope of medical insurance fund payment, the limit is 150 yuan/piece;

3, dental implant, dental implant restoration and tooth whitening and other medical projects;

4. Overall fund payment, that is, 85% for medical insurance and 0/5% for individual/kloc.

The process of medical insurance reimbursement:

1, medical treatment: go to a hospital or clinic for medical treatment or treatment;

2. Payment: Pay the medical expenses that should be paid in the hospital or clinic;

3. Obtain a list of expenses: during the medical treatment, the hospital or clinic will provide a list of expenses, which lists the specific medical items and amount;

4. Fill in the reimbursement application form: hold the expense list and fill in the medical insurance reimbursement application form. You need to provide your own basic information, medical expenses list, medical insurance certificate and other related materials when filling in;

5. Submit materials: submit the completed reimbursement application form and related materials to the medical insurance agency, which can be submitted online or offline;

6. Audit: The medical insurance agency shall audit the submitted application forms and materials. After the approval, the medical insurance agency will transfer the reimbursement to the personal bank account or give cash reimbursement.

To sum up, different regions and different medical insurance systems may have different participation conditions, payment standards and reimbursement scope. When participating in medical insurance, residents need to understand local laws and policies and consult the staff of local social insurance agencies.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.