Can medical insurance be used in stomatology?

Whether the stomatology department can use medical insurance depends on the situation. Dental filling and tooth extraction can be reimbursed by medical insurance, but orthodontics can't.

The scope of medical insurance reimbursement for stomatology is as follows:

1, tooth filling (including basic materials and treatment fees);

2, tooth extraction;

3, the cost of treating periodontal disease, gingivitis and other dental diseases.

The items that cannot be reimbursed by medical insurance are as follows:

1, dentures;

2. porcelain teeth;

3. Wash your teeth;

4. Orthodontics;

5, whitening teeth;

6, dental implants malt dental implants, orthodontics.

Medical insurance reimbursement process:

1, diagnosed and treated in the designated medical insurance hospital.

Every city will have designated hospitals for medical insurance. Only when you are treated in a designated medical insurance hospital can you be reimbursed by medical insurance. Therefore, if you want to use medical insurance, you must go to the designated hospital for medical insurance and go through the relevant registration procedures;

2. Prepare discharge information

Prepare discharge materials in advance when you leave the hospital, such as disease diagnosis, discharge records, medical records, etc. Usually talk to the doctor during treatment. If we need these materials, the doctor will help us prepare them. You'd better make a copy of these materials after you get them. One is submitted to the medical insurance reimbursement office, and the other is reserved for use;

3. Discharge settlement

Take the hospitalization list and invoice to the hospital for settlement. After that, you can take the relevant information to the medical insurance reimbursement department for reimbursement review;

4. Wait for the expense reimbursement to arrive.

A receipt will be received after the data is handed over, and the reimbursement amount will be received within 15 days. You just have to wait patiently.

To sum up, treatment items such as tooth extraction (including basic materials and treatment expenses), tooth filling and periodontal disease are all covered by dental insurance reimbursement. Besides changing teeth, you can't use medical insurance to make porcelain teeth or all-ceramic teeth.

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.

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.