Dental implants belong to the category of medical beauty, and like dental beauty projects such as dental inlay and orthodontics, they cannot be reimbursed, and the insured needs to bear the corresponding expenses.
The scope of medical insurance reimbursement for dental treatment is as follows:
1, which has been included in the scope of medical insurance, mainly covers the expenses of tooth filling (basic materials and treatment fees), tooth extraction, treatment of periodontal disease, gingivitis, root canal treatment and other dental diseases. The extraction of common wisdom teeth belongs to the scope of medical insurance card reimbursement and can be paid by medical insurance fund;
2. The non-reimbursable scope is usually the category of tooth restoration and whitening, such as tooth inlay, porcelain restoration, orthodontics, tooth implantation, tooth whitening and so on. In China's medical field, it belongs to the restoration project of medical beauty evaluation model, and it can only be reimbursed at its own expense, not by medical insurance. Dental implant costs are mainly material costs, such as porcelain teeth and dental implants, which are usually approved by the price department and belong to special service costs and cannot be reimbursed by medical insurance;
3. The medical expenses incurred by the dental clinic examination and treatment shall be paid by the personal account of the social security card. If the patient is admitted to hospital due to illness and meets the hospitalization standard, other expenses can be settled according to the provisions of medical insurance, except that the denture (denture) expenses cannot be paid by the medical insurance pooling fund.
The materials required for medical insurance reimbursement are as follows:
1, hospitalization medical record issued by the attending doctor when the individual is hospitalized;
2. List of hospitalization expenses;
3. Various invoices for hospitalization expenses;
4, hospital financial discharge summary;
5. The disease diagnosis certificate issued by the attending doctor;
6. The patient's ID card and household registration book;
7. Social security card for medical practitioners.
To sum up, the insured person can register with the designated medical institution in the insured place with the medical insurance card and go to the stomatology department to see the dentist. The medical expenses incurred by filling teeth are paid by the medical insurance fund and can be reimbursed. However, dental implants and dental implants belong to the category of medical beauty and 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.