Reimbursement and Non-reimbursement Items in Dental Expense-Insurance Chapter

About the insurance reimbursement request:

Public hospital visits, consistency between diagnosis and treatment details and the total amount of invoice, and complete medical records are the first condition to enjoy dental expenses reimbursement. In addition, the cost of dental care can be reimbursed depending on the treatment program and the materials used.

General non-reimbursement items

1. Denture: ordinary denture, such as  there are tooth No.1, 2and 3, among which the second tooth is pulled out for some reason. So make dental caps (3 porcelain crowns) for the three teeth, put them on 1st and 3rd respectively, and then the second tooth is fixed too. But the premise is that tooth No. 1 and 3 must be worn off a thick layer for the crown. The advantage of this method is that it is cheaper than dental implant, and the disadvantage is that the two good teeth No.1 and 3 are damaged.

2. Dental implant: As mentioned above, among the tooth No.1, 2 and 3, the second tooth is pulled out for some reason. Dental implant is to implant a nail into the alveolar bone on the location of tooth No.2, and then an independent porcelain crown is implanted on the head of the nail. The advantage of this method is that it has nothing to do with the adjacent teeth, but it is relatively expensive.

3. Denture restoration: including the post crown, dental crown, complete denture, partial denture etc.

4. Orthodontics: orthodontic treatment is needed due to irregular teeth.

5. Repair: The use of imported high-end materials cannot be reimbursed generally, but the use of ordinary materials can be reimbursed.

6. Stained tooth treatment and other estheticdentistry items

7.Simple teeth wash, or when the teeth wash is required for the treatment, the costs involved in esthetic dentistry.

Reimbursement items

1.Tooth extraction

2.Tooth filling: including ordinary materials and treatment fees.

3.Oral hemostasis, periodontal disease, pulpitis, periapical periodontitis, root canal therapy, toothache and other disease treatment costs

General reimbursement ratio and form (general departments of public hospitals)

1.Outpatient for disease: There is a daily limit of 600 yuan ( the cost within the daily limit after deduction of the expenses paid by oneself); there is a minimum charge, and the payout ratio is 85%. That is (the total amount within daily limit-minimum charge)*85%= Reimbursement amount

2.Outpatient for accident: Subtract the non-reimbursement expense, 100% of the rest expense

2017-06-23  FENXIANG