Amount division:
When applying for reimbursement of outpatient medical expenses, the applicant should first deduct the amount transferred to the personal account of medical insurance in this social security year, and then verify the amount to be reimbursed.
Included in medical insurance coverage are:
The cost of treating periodontal disease, gingivitis and other dental diseases.
However, the specific reimbursement ratio needs to refer to specific local regulations. The cost of tooth extraction belongs to the scope of medical insurance reimbursement, and filling teeth does not belong to the scope of medical insurance reimbursement. College students participate in social security according to local urban residents' medical insurance. At present, what has been included in the scope of medical insurance is mainly the cost of filling teeth (using basic materials), extracting teeth and treating periodontal diseases, gingivitis and other dental diseases.
Formal process:
1. Oral curved section or oral ct is needed to observe the condition of wisdom teeth.
2. It is necessary to take a blood test to observe whether the coagulation mechanism of the body is normal, and then determine whether the wisdom teeth have acute inflammation. Third, it is necessary to extract wisdom teeth under local anesthesia, analyze the resistance of wisdom teeth, and finally extract wisdom teeth.
Pull out category:
1, inflammation or pain of wisdom teeth
In fact, not all wisdom teeth need to be removed in oral clinical surgery. However, in daily life, wisdom teeth are out of position and lack of space, so it is difficult to clean them, which may easily lead to tooth decay, inflammation or pain. It must be removed in time at this time.
2. wisdom teeth cause pericoronitis
If wisdom teeth have caused pericoronitis, they must be removed. Pericoronitis will make the dental arch smaller and smaller, and the wisdom teeth will swell and ache when they erupt. If you want to avoid this from happening again, you should remove your wisdom teeth as soon as the inflammation subsides.
3, wisdom teeth have no teeth.
Wisdom teeth without teeth should also be pulled out as soon as possible. If wisdom teeth erupt normally without causing inflammation or pain, but there are no opposite occlusal teeth, they also need to be removed in this case, otherwise other teeth will be affected.
4, decayed wisdom teeth
If the wisdom teeth are decayed, although the symptoms can be improved by cleaning and filling the teeth, it will affect the adjacent teeth and probably lead to dental caries. It is better to pull them out as soon as possible.
5. Impacted wisdom teeth
In fact, impacted wisdom teeth are the most troublesome situation. This kind of bracket does not erupt, but is buried in alveolar bone, which is easy to cause tooth inflammation and must be removed as soon as possible.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 27
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Article 28
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.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.