Can the medical insurance card reimburse you for wearing braces?

The medical insurance card cannot reimburse you for wearing braces.

If the items, materials, and drugs involved in the dental filling process fall within the scope of medical insurance, the filling dental insurance can be reimbursed. Teeth cleaning, dental veneers, and orthodontics are not reimbursed and fall within the scope of dental beauty.

Dental filling insurance can only provide medical insurance for a part of it. The key depends on whether the items, materials, and drugs involved in the filling process are covered by medical insurance. If the dental filling is covered by medical insurance, fillings can be performed. Medical insurance reimbursement.

Medical insurance coverage:

1. Basic medical insurance drug reimbursement

Our country now divides drugs into three categories: A, B, and C. Among them, Category A drugs are It is within the scope of medical insurance, so only Category A drugs can be reimbursed by medical insurance, while Category B and Category C drugs cannot be reimbursed;

2. Reimbursement of basic medical service facilities

This reimbursement scope mainly refers to the bed fees, emergency bed fees, consultation fees, etc. incurred during the process of diagnosis, treatment and care at designated medical insurance institutions by the insured;

3. Basic medical care Reimbursement of insurance diagnosis and treatment items

must be safe and effective diagnosis and treatment, and the charging standards are determined by the price department. Treatment is required at a designated medical institution.

Medical insurance reimbursement process:

1. Diagnosis and treatment in medical insurance designated hospitals

Every city will have a medical insurance designated hospital. Only diagnosis and treatment in a medical insurance designated hospital can Can use medical insurance to reimburse. Therefore, if you want to use medical insurance, you must go to a designated hospital for medical insurance and complete the relevant registration procedures;

2. Prepare discharge information

After discharge Prepare discharge information in advance, such as disease diagnosis certificates, discharge records, and medical records. Generally, during treatment, we tell the doctor that we need these materials, and the doctor will help us prepare them. It is best to make a copy after getting these materials. Submit one copy to the medical insurance reimbursement office and keep the other for backup;

3. Discharge settlement

Take the hospitalization list and invoice and complete the settlement procedures in the hospital. After that, you can take the relevant information to the medical insurance reimbursement department for reimbursement and review;

4. Wait for the reimbursement to arrive

After the information is handed over, you will receive it The reimbursement amount will be received within 15 days based on the receipt form. You just need to wait patiently.

To sum up, medical insurance cannot reimburse for orthodontics because it does not comply with relevant legal regulations.

Legal basis:

Article 28 of the "Social Insurance Law of the People's Republic of China"

Comply with the basic medical insurance drug catalog, diagnosis and treatment items, Standards of medical service facilities and medical expenses for emergency and rescue services shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit .

The social insurance administrative department and the health administrative department should establish a medical expense settlement system for medical treatment in other places to facilitate insured persons to enjoy basic medical insurance benefits.