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牙科费用报销与不报销的项目

来源:留学保险网 最后更新:2019-10-24 10:30:58 作者:留学保险项目组 浏览:24648次

就医提醒:

Tips for visting dentist:

公立医院普通科室。

就诊资料齐全,包括:发票原件或电子发票、费用明细、病历(就诊后请向医生索要当日就诊病历)。

材料齐全是理赔申请的首要条件。另外,牙齿治疗的费用能否报销,要根据治疗项目和使用材料而定。

When visiting a public hospital, complete medical documents are needed to apply for reimbursement of dental care expenses, including: original invoice or electronic invoice, fee details, medical records; please ask the doctor to give you medical records after every visit. In addition, the cost of dental treatment can be reimbursed depending on the treatment program and the materials used.

 

可以报销的项目

Reimbursement

1.拔牙;Tooth extraction

2.补牙:包括普通材料费和治疗费;Tooth filling: including ordinary materials and treatment fees.

3.口腔止血、牙周病、牙髓炎、根尖周炎、根管治疗、牙疼等疾病的治疗费用。Oral hemostasis, periodontal disease, pulpitis, periapical periodontitis,root canal therapy, toothache and other disease treatment costs

报销规则 (800元方案为例)

General reimbursement conditions(800yuan package as example)

按照保险责任中的门急诊责任报销,报销规则:

● 日限额600元限制(不包含自费费用);

● 免赔额650元;

● 赔付比例85%;

即(日限额以内的金额合计 - 免赔额)*85%=实际报销金额。

(the expense of each day within the daily limit RMB600 yuan add up-650 yuan) * 85%=reimbursable amount (the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the basic medical insurance)

 

不可报销的项目:

General non-reimbursement items

1.镶牙:譬如1、2、3这3个牙齿,其中2因故而拔掉了。于是做一个3个牙齿的帽子(就是3个烤瓷冠)的牙,分别套在1和3的上面,这样2也就镶好了;Denture: where the middle tooth is pulled out and fixed but porcelain crowns are made for all three teeth (the fixed tooth as well as the teeth on either side.

2.种牙:如上所说,1、2、3这3个牙齿,其中2因故而拔掉了。种牙是就在2的位置种一个钉子到牙槽骨里,然后在钉子的头上镶一个独立的烤瓷牙冠;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.

3.义齿修复:如桩冠、套冠、全口义齿、局部义齿等;Denture restoration: including the post crown, dental crown, complete denture, partial denture etc.

4.正畸:牙齿不整齐而进行矫正治疗;Orthodontics: orthodontic treatment is needed due to irregular teeth.

5.修补:使用进口等高端材料(指当地医保不报销的材料和项目)费用一般不能报销,使用普通材料可以报销;Repair: The use of imported high-end materials(materials and items that are not covered by local medical insurance) cannot be reimbursed generally, but the use of ordinary materials can be reimbursed.

6.色斑牙治疗等美容美牙项目;Stained tooth treatment and other esthetic dentistry items.

7.洗牙(通常体现为洁治,龈上洁治、龈下刮治、牙面抛光等)。Dental cleaning (It is usually embodied in cleaning, supragingival cleaning, subgingival scraping, tooth surface polishing, etc.) or the cost involved when dental cleaning is required for treatment.

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