Medicare can fillings reimbursement

The dental insurance can not be reimbursed. Most of the operations of the dental department belong to the outpatient category, hospitalization health insurance is not able to start reimbursement, and fillings are mostly imported resin materials, even if you want to use the money in the health insurance card is also more difficult, so the patient fillings need to pay in cash. The cost of fillings varies according to the choice of filling material, from 150-450 dollars, and even the good ones can reach about 900 dollars, and the more expensive the material, the less likely the balance of the medical insurance, because the imported materials are not considered to do the scope of treatment. But if a tooth has a cavity, it is important to fill the tooth in time for treatment, and if it is not treated in the early stages and develops into pulpitis, the cost of treatment may be doubled.

I. What are the items included in the medical insurance reimbursement?

According to the regulations, the basic medical insurance does not pay the cost of diagnosis and treatment items *** five categories.

The first category is the class of service items: part of the medical service fee, out-of-hospital consultation fee, medical records cost, etc.; out of the clinic fee, examination and treatment of expedited fee, named surgery surcharge, named surgery surcharge, quality premium fee, self-requested special nurses and other special medical services.

The second category is the category of non-disease treatment programs: see the following analysis.

The third category is the category of diagnostic and therapeutic equipment and medically useful materials: the application of positron emission tomography device (PET), electron beam CT, ophthalmic excimer laser treatment instrument and other large-scale medical equipment for examination and treatment programs. Eyeglasses, denture, eye prosthesis, prosthetic limbs, hearing aids and other rehabilitative devices. All kinds of health care, examination and treatment equipment for personal use. Provincial price departments do not charge separately for disposable medical materials.

The fourth category is the category of therapeutic projects: all types of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation; myopic orthopedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other complementary therapeutic projects.

The fifth category is other categories: various scientific research, clinical verification of the diagnosis and treatment program.

In addition, the basic medical insurance does not pay the cost of transportation, emergency vehicle fees; baby warming box fee, food warming box fee, nursing fee, cleaning fee, outpatient decoction fee; meal costs and other special needs living services. The patients will have to pay for the costs of the above items when they seek medical treatment.

Second, the medical insurance reimbursement process:

1, the original ID card or social security card;

2, the original diagnosis of disease certificate issued by a specialist doctor of the third or second level of hospitals in the designated medical institutions;

3, the original outpatient medical records, examination, test results report card, and other medical information;

4, the financial, tax unified medical institutions Outpatient fee receipts;

5, the hospital ** printed list of outpatient expenses or the doctor issued a prescription for the payment of the original;

6, fixed-point pharmacy: tax unified invoice for the sale of goods and ** printed list of the original;

7, such as the proxy to provide the original identity card of the proxy.

Legal basis:

The People's Republic of China*** and the State Social Insurance Law

Article 28 of the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical services and facilities, as well as emergency and rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.