The extraction of wisdom teeth can be reimbursed using the medical insurance, but the reimbursement of dental expenses have strict regulations, only the nature of the dental treatment, can be reimbursed with the medical insurance, such as fillings, extractions, and the treatment of periodontal disease, gingivitis and other dental expenses. However, medical cosmetic items cannot be reimbursed by the medical insurance card, such as orthodontic treatment, teeth whitening and other expenses. The general reimbursement range is: working employees in accordance with 50% reimbursement, 75-80% reimbursement for retired employees, but must be the health insurance designated dental hospital or hospitals with the qualification to engage in dental, must be in the health insurance designated reimbursement hospitals, but the cost of extracting the teeth is not reimbursed, extraction, fillings belong to the treatment of the category.
For example, if you need 1,000 yuan to extract a wisdom tooth, you will be reimbursed 50 percent of the cost, or 1,000 * 50 percent = 500 yuan, according to the calculation of the working staff. If the water infusion is covered by health insurance, it is directly reimbursed by health insurance, which means that the wisdom teeth extraction needs at least 500 yuan. And the medical insurance reimbursement part of the outside, you can also use their own medical insurance card balance (requirements higher than 500), so they do not have to spend money. As noted in the regulations, fillings generated by the medical expenses of the medical insurance fund to pay for the cost of the scope of the expenses, you can directly brush the medical insurance card to pay; but veneers, dental implants are the scope of medical cosmetic, can not brush the medical insurance card to pay for the cost of the expenses, you need to pay out of pocket; so the specific can be reimbursed depending on whether or not the veneers, dental implants and other medical cosmetic; general reimbursement of the cost of 50 percent -80 percent.
Social health insurance is also known as "sickness social insurance" or "health social insurance". The insured person due to disease, injury, disability, etc. caused by the loss of income interruption and medical expenses, the insurance organization to provide material assistance of a kind of social insurance. It includes sickness benefits and health care, i.e., payments for medical treatment, special medical treatment, outpatient care, hospitalization, home care services, and pharmaceutical supplies. The scope of sickness insurance varies considerably from country to country, depending on the level of national economic development and the social system. Some countries cover the entire population, while others limit it to employed workers. Funding sources, most countries provide by the employee and employer *** together, the state to give some subsidies.
Medicare reimbursement
I. Scope of treatment items for which the basic insurance does not cover the costs
(1) Service item category
1, registration fee, out-of-hospital consultation fee, medical record cost, etc.;
2, consultation fee, expedited fee for examination and treatment (except for emergencies), surcharge on surgery by name, high quality and premium fee, self-invited special nurses' fee, and other special-needs medical services.
(2) non-disease treatment program category
1, a variety of cosmetic (cosmetic life, medical cosmetology) fitness program as well as messy non-functional cosmetic surgery, orthopedic surgery, etc.;
2, a variety of weight loss, gain weight, increase in height projects;
3, a variety of health checkups;
4, a variety of preventive, health care treatment programs;
(C) diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography device, electron beam CT, ophthalmic excimer laser treatment instrument and other large-scale medical equipment for the examination and treatment of the project;
2, eyeglasses, dental prostheses, eye prostheses, prosthetic limbs, hearing aids, and other rehabilitation appliances;
3, all kinds of health care for their own use, massage, examination, rehabilitation and treatment of the device.
(4) therapeutic items category
1, all kinds of organ transplantation or tissue transplantation of organ source or tissue source;
2, in addition to kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplantation other organs or tissue transplantation;
3, myopic eye orthopaedics;
4, qigong therapy, music therapy, health care of the nutritional therapy, magnetic therapy and other complementary treatment programs.
(5) Other
1, all kinds of infertility (pregnancy), sexual dysfunction diagnosis and treatment programs;
2, all kinds of scientific research, clinical verification of diagnosis and treatment programs;
2, basic medical insurance to pay for part of the cost of the diagnosis and treatment program range
1, social health insurance card, referred to as the medical insurance card or medical card, is the health insurance It is a special card for personal account, which takes personal ID card as its identification code and stores detailed information such as personal ID card number, name, gender, and the allocation and consumption of the account. The medical insurance card is organized by the local designated agent bank and is a kind of multi-functional debit card of the bank. After the insured unit pays its contribution, the local health insurance department will entrust the bank to pay the individual account fund to the insured employee's personal health insurance card at the end of the month.
2. The social medical insurance card, referred to as the medical insurance card or medical insurance card, is a special card for the medical insurance individual account, with the personal ID card as the identification code, storing and recording the personal ID card number, name, gender, as well as the account of the allocation of funds, consumption and other detailed information. The medical insurance card is organized by the local designated agent bank and is a kind of multi-functional debit card of the bank. After the insured unit pays its contribution, the local medical insurance department will entrust the bank to pay the individual account fund to the insured employee's personal medical insurance card at the end of the month.
Legal basis
Social Insurance Law
Article 28 meets the standards of the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facilities, as well as emergency and rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.
Social Insurance Law
Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a system of settlement of medical expenses for medical treatment in other places to facilitate the enjoyment of basic medical insurance by insured persons.