How much can medical insurance for wisdom teeth be reimbursed?

The proportion of medical insurance reimbursement for wisdom tooth extraction varies according to different situations.

Generally speaking, on-the-job employees can be reimbursed 50%, and retired employees can be reimbursed 75-80%. The specific reimbursement amount also needs to be determined according to the medical insurance policy and the cumulative consumption of individual medical insurance accounts. For example, if a patient used a medical insurance card to see a doctor in Beijing, and the previous outpatient expenses had exceeded the medical insurance deductible line 1800 yuan, then this time only a part of the treatment expenses were paid by himself, and individuals need to pay in advance. The rest are within the scope of medical insurance and can be reimbursed according to the proportion of medical insurance reimbursement in Beijing.

The process of medical insurance reimbursement for wisdom teeth extraction varies according to regions and types of medical insurance. The following is the general process:

1. Preparation before seeing a doctor: Before seeing a doctor, make sure that you have participated in medical insurance and understand the local medical insurance policy and reimbursement process.

2. Choose a designated medical institution with medical insurance: When removing wisdom teeth, choose a designated medical institution with medical insurance for medical treatment.

3. Registration and medical treatment: register at the selected medical institution and go to the Department of Stomatology for medical treatment.

4. Medical insurance expense settlement: After the visit, go to the financial department of the hospital for medical insurance expense settlement.

5. Submit an application for reimbursement (if necessary): If the expenses paid by individuals are high, you can submit an application for reimbursement to the local medical insurance department.

5. Review and reimbursement.

To sum up, the specific medical insurance policy for wisdom tooth extraction may vary from region to region. It is suggested that patients consult the local medical insurance office or the hospital medical insurance office before seeing a doctor to obtain the most accurate information.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

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 30

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

(a) shall be paid from the industrial injury insurance fund.

(2) borne by a third party.

(three) shall be borne by the 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.