How to get reimbursed for dental treatment by medical insurance

Medicare can cover part of the cost of dental treatment, but the specific reimbursement rate and scope may vary depending on the region, the type of medical insurance and the treatment program.

One, understand the health insurance policy

First of all, you need to understand the local health insurance policy, including the type of health insurance, reimbursement rate, reimbursement scope, and so on. This information can be obtained through the local health insurance bureau, social security center or hospital. Understanding the health insurance policy will help clarify which treatments can be reimbursed and how they can be reimbursed.

Second, choose a medical insurance designated medical institutions

In order to ensure that you can be reimbursed successfully, it is recommended that you choose a medical insurance designated medical institutions for dental treatment. These medical institutions usually have a partnership with the medical insurance department and are able to provide services that meet the requirements of the medical insurance.

Three, prepare the relevant supporting documents

Before the treatment, you need to prepare the relevant supporting documents, including the medical insurance card, ID card, medical records, etc. These documents are necessary for reimbursement. These documents are necessary for reimbursement and must be kept in a safe place.

Fourth, the treatment and ask for a breakdown of the cost

When receiving dental treatment in a medical institution, you should ask the doctor to issue a detailed breakdown of the cost. The cost details should show the name and price of each treatment item, as well as the portion paid by the medical insurance and the portion paid by the individual.

Fifth, submit a reimbursement application

After the treatment is completed, submit a reimbursement application in accordance with the requirements of the health insurance department. Usually, you need to fill out a reimbursement application form and attach relevant supporting documents and cost details. Reimbursement applications can be submitted through online or offline channels, and you can consult your local health insurance department for details.

Sixth, wait for audit and settlement

After submitting the reimbursement application, the medical insurance department will conduct an audit. After passing the audit, the medical insurance department will settle the claim in accordance with the stipulated rate and scope, and credit the reimbursement amount directly to the individual's medical insurance account or designated bank account.

In summary:

The reimbursement of dental treatment by medical insurance requires understanding of the medical insurance policy, choosing a designated medical institution, preparing relevant supporting documents, treating the patient and requesting a detailed breakdown of the costs, submitting the reimbursement application, and waiting for the audit and settlement. During the reimbursement process, it is important to follow the rules and requirements of the health insurance department to ensure a smooth reimbursement process.

Legal basis:

The Law of the People's Republic of China on Social Insurance

Article 28 stipulates that:

Medical expenses that are in accordance with the drug list, diagnostic and therapeutic items, and standards of medical service facilities for basic medical insurance as well as those for emergency treatment and resuscitation shall be paid out of the basic medical insurance fund in accordance with state regulations.