Which items of stomatology can be reimbursed by medical insurance?

Dentistry is mainly incorporated into medical insurance coverage:

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

2, tooth extraction;

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

Items that cannot be reimbursed by medical insurance are:

1, dentures;

2. porcelain teeth;

3. Wash your teeth;

4. Orthodontics;

5. dental implants;

Both tooth extraction and filling are covered by medical insurance. However, dental implants and tooth washing are not covered by medical insurance. If it is therapeutic, such as tooth extraction is within the scope of medical insurance reimbursement, then dental implants are not.

Some dental treatments belong to the medical insurance category, such as tooth extraction and filling. (excluding imported materials) can use medical insurance; Dental implants and tooth washing are not in medical insurance coverage. The medical expenses incurred in the examination and treatment in the dental clinic shall be paid by the social security card personal account funds. If the patient is admitted to the hospital due to illness and meets the hospitalization standard (except that the denture expenses cannot be paid by the medical insurance pooling fund), other expenses can be settled according to the medical insurance regulations. At present, according to the national medical reimbursement regulations, dental treatment expenses and surgical expenses are mainly included in the scope of medical insurance, such as tooth filling (basic materials and treatment expenses), root canal treatment, tooth extraction, tooth filling, periodontal treatment, gingivitis and so on. Tooth beauty mainly includes tooth inlay, porcelain teeth, tooth cleaning, orthodontics, tooth implantation and so on. These price departments are designated as special service fees and cannot be reimbursed by medical insurance. Whether the teeth can be covered by medical insurance is related to the regulations of the local medical insurance bureau and the content of treatment. For example, dental caries and periodontal diseases are generally acceptable, but oral repair and beauty are generally not. _ According to the current medical reimbursement regulations in China, dental treatment is mainly included in the scope of medical insurance, such as dental caries and periodontal diseases, and the reimbursable treatments mainly include tooth filling, root canal treatment, tooth extraction, periodontal scaling and periodontal scaling. The specific reimbursement ratio varies. _ If it is a dental restoration or cosmetic project, such as missing teeth, malocclusion and so on. Corresponding treatment methods, such as dental inlay, orthodontics, tooth implantation, tooth whitening, etc. , not within the scope of medical insurance reimbursement. _ It is suggested to consult the relevant regulations of the local medical insurance bureau and hospital to find out whether medical insurance can be used, the proportion of medical insurance and how to reimburse it.

Legal basis:

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

Article 2 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 receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.