Job Recruitment Website - Social security inquiry - Can medical insurance be used for correction?
Can medical insurance be used for correction?
Orthodontics includes irregular teeth, crowded teeth and abnormal dentition. It belongs to medical cosmetic surgery and does not belong to the category of diseases. Under normal circumstances, medical insurance cannot be reimbursed. In addition, denture repair is not covered by medical insurance reimbursement. When gingivitis, tooth extraction, root canal treatment and other dental diseases appear in the medical insurance policy list, they can be reimbursed by medical insurance.
Medical insurance reimbursement process of dental clinic:
1, the insured submits all the documents and vouchers required for reimbursement to the relevant local authorities;
2. Just wait for the social security agency to handle it, or you can directly reimburse it in the hospital, that is, when you go through the hospitalization procedures, you can directly participate in the reimbursement by issuing a new rural cooperative medical certificate to the hospital.
Proportion of reimbursement for dental medical insurance:
Dental medical insurance reimbursement can only be partial, not all. In case of hospitalization expenses, the minimum payment standard for employees and retired employees to use for the first time within one year is 1300. If it is the second hospitalization, according to 50% of the minimum payment standard, the maximum treatment cost that medical insurance can pay within one year is 70,000 yuan.
The reimbursement rate of township hospitals and community health service institutions is not less than 80%, the institutions above the county level are not less than 70%, and the municipal hospitals are not less than 60%.
Medical insurance coverage:
1, drug reimbursement for basic medical insurance
Our country now divides drugs into three categories: A, B and C, among which A drugs are within the scope of medical insurance, so medical insurance can only reimburse A drugs, and B and C drugs cannot be reimbursed;
2. Reimbursement of basic medical service facilities
This reimbursement scope mainly refers to bed fees, first-aid bed fees, consulting fees, etc. Expenses incurred by the insured in the process of diagnosis, treatment and nursing in designated medical insurance institutions;
3, the basic medical insurance treatment project reimbursement
It must be a safe and effective diagnosis and treatment, and the charging standard shall be determined by the price department. Need to be treated in a designated medical institution.
To sum up, orthodontics is not covered by medical insurance, so it cannot be reimbursed.
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.
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