How much medical insurance can be reimbursed for tooth extraction?

Within the scope of medical insurance, hospitalization surgery for wisdom teeth extraction due to medical needs can be reimbursed to a certain extent, and the reimbursement ratio varies with regions, hospitals and other factors.

In the medical insurance catalogue, under normal circumstances, only hospitalization and wisdom tooth extraction caused by medical necessity can get medical insurance reimbursement. According to different national and local policies, the reimbursement ratio is also different. Taking Beijing as an example, the reimbursement rate of residents' medical insurance is 60% (the maximum amount is 1952.8 yuan), and employees' medical insurance can cover 100% of the actual expenses. At the same time, there are differences among different levels of hospitals. Generally speaking, the reimbursement rate of top three hospitals will be higher. It should be noted that even the tooth extraction treatment caused by medically necessary reasons needs to be carried out under the guidance of a doctor, and relevant medical proof materials, such as diagnosis certificates and hospital medical records, need to be provided. Otherwise, the reimbursement result may be affected.

Besides medical insurance reimbursement, are there any other reimbursement methods for tooth extraction expenses? If an individual has purchased commercial medical insurance, he can also find out whether the tooth extraction treatment project is included according to the types of insurance purchased and the terms of the insurance policy, and make reimbursement in commercial medical insurance coverage on the premise of meeting the relevant regulations of the insurance company. In addition, social assistance systems in some cities also have medical assistance programs for poor patients who can't afford tooth extraction. It should be noted that the above supplementary reimbursement methods all need to meet the corresponding conditions and regulations, and cannot be applied and used at will.

Within the scope of medical insurance, only the removal of wisdom teeth in the hospital caused by medical necessity can get a certain proportion of reimbursement. At the same time, we can also reduce the burden of tooth extraction by purchasing commercial medical insurance or seeking assistance from poor patients. It should be noted that all kinds of reimbursement methods need to meet the corresponding conditions and regulations, and cannot be applied and used at will.

Legal basis:

Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, standards of medical service facilities and medical expenses for emergency rescue, and shall be paid from the basic medical insurance fund in accordance with state regulations.