What is the price of tooth extraction with health insurance and how much is covered? What are the specific details regarding tooth extraction with health insurance? All of these questions will be answered specifically by BeDental in the following article, so please refer to it.
What is health insurance? Conditions for enjoying health insurance benefits in dental treatment
Not everyone is required to have health insurance. Some individuals may voluntarily register to enjoy all the benefits. So, what is the function of a health insurance card?
With a health insurance card in hand, you will receive comprehensive healthcare while saving a significant amount of costs. Specifically, by possessing a health insurance card, the insurance agency will partially or even fully cover the fees for medical examinations, treatments, and prescribed medications.
So, can dental treatment be covered by health insurance? The answer is YES. The health insurance law clearly stipulates the cases in which health insurance supports the payment of dental treatment expenses. And to enjoy health insurance benefits in dental treatment, you need to:
- For individuals who are newly enrolled in health insurance, the effective period starts 30 days after payment.
- Participate in health insurance and ensure that the insurance card is still valid when presenting it.
- If transferring for treatment, you need to provide a referral letter from the hospital or healthcare facility confirming the transfer.
- Belong to one of the cases of dental treatment that is supported by health insurance. Specifically, this refers to cases that are recommended by a dentist and not solely based on personal aesthetic needs. For example, wisdom tooth extraction as recommended by a dentist.
Does dental extraction with health insurance have coverage?
Does dental extraction with health insurance have coverage? Based on Article 21 of the Health Insurance Law, you will still receive reimbursement for the costs of tooth extraction. However, not all cases of tooth extraction are covered by insurance, either partially or fully.
You need to be familiar with the current regulations of the law to determine if your case is eligible for insurance reimbursement.
So how do you know which cases are not covered by health insurance for tooth extraction? Based on Article 23, we can easily determine whether reimbursement is available and how much the cost of tooth extraction with health insurance is. Specifically:
- If you undergo tooth extraction for serious dental conditions, as diagnosed by the dentist through examinations and dental imaging, such as deep cavities, pulpitis, periodontitis, cracked teeth, irreparable teeth, etc., you will be covered by insurance according to the corresponding benefits.
- On the other hand, if you choose to have tooth extraction solely for cosmetic purposes without a dentist’s recommendation, you will not receive any reimbursement from the health insurance budget. This means that health insurance will not have any effect in this case. In addition to cosmetic tooth extraction, tooth extraction for participation in scientific research studies will also not be covered by insurance.
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Cases of tooth extraction with 100% coverage by health insurance
In addition to the question of how much tooth extraction with health insurance costs, it is important to determine whether you are eligible for coverage. By studying the law, you can easily find out whether your case of tooth extraction will be covered or not. In summary, cases of tooth extraction that are covered by health insurance include:
- Severely decayed teeth that have affected the pulp and cannot be preserved. In this case, the dentist will recommend tooth extraction to eliminate the deep cavity and prevent it from spreading to neighboring teeth.
- Impacted, submerged, or misaligned tooth number 8 that causes complications with other teeth should be extracted as early as possible.
- Infected teeth that require extraction before continuing with treatment.
- Accidents, strong impacts, etc., that cause tooth fractures and cannot be restored. Tooth extraction in such cases is the optimal choice and will be recommended by a specialist dentist.
Does dental extraction with health insurance have coverage? Which types of insurance provide coverage?
Tooth extraction is a common dental procedure. In certain special cases, patients may need to undergo tooth extraction. So, does health insurance cover tooth extraction?
Alongside health insurance coverage for medical treatment, tooth extraction is also covered by certain types of insurance. This means that some health insurance providers may share the cost of your tooth extraction if you meet the necessary criteria for reimbursement. So, which types of insurance provide coverage for tooth extraction?
Tooth extraction insurance from life insurance companies
Health insurance packages from life insurance companies are often linked to top dental clinics in Vietnam. Therefore, the use of insurance cards for dental treatment, including tooth extraction, is widely accepted.
Regarding dental benefits provided by life insurance cards, cases of tooth extraction due to dental conditions are covered based on the initial contract limits. The higher your card limit, the larger the reimbursement you will receive for tooth extraction due to dental conditions.
Note: Most life insurance brands have two categories: main benefits and supplementary benefits. The main benefits include various other protected items, while supplementary benefits cover dental benefits.
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Dental insurance from banks
Currently, many banks offer dental health insurance services. For example, PVI, BIDV, Vietinbank, etc. When you have a dental health insurance card from these banks, you will receive reimbursement for tooth extraction due to dental conditions at hospitals, state medical centers, or dental clinics under the bank’s insurance guarantee system.
Insurance provided by hospitals
Many hospitals now offer dental insurance to meet the oral health care needs of customers. Examples include Vinmec Hospital, Hong Ngoc Hospital, and Thu Cuc Hospital, which all offer dental insurance packages.
Reimbursement for tooth extraction due to dental conditions is provided when you have the extraction performed at these hospitals. The higher the limit, the larger the reimbursement.
What is the price of tooth extraction with health insurance, and how much is deducted?
The price of tooth extraction with health insurance and the amount deducted is always a concern for many customers. In reality, customers who have health insurance always hope that their medical expenses will be reduced to alleviate financial pressure when visiting hospitals.
So, what is the truth about the price of tooth extraction with health insurance and how much is deducted?
The reimbursement for tooth extraction with health insurance varies depending on each case, with different costs covered. Some customers receive reimbursement for tooth extraction with health insurance at a deduction rate of 100%, 80%, or 60%.
So why is there such a difference? How does the price of tooth extraction with health insurance apply to these individuals, resulting in variations?
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Tooth extraction with health insurance is 100% deductible for the following individuals:
- Those who have contributions to the revolution, veterans, those who receive monthly social benefits, those living in poverty, and those aged 80 and above who receive monthly disability benefits.
- Those who participated in the revolution before January 1, 1945, those who participated in the revolution from January 1, 1945, to August 1945, heroic Vietnamese mothers, type B disabled veterans or those with a disability rate of 81% or higher, and those who participated in the resistance against Agent Orange and have a disability rate of 81% or higher.
- Those who participate in health insurance and receive treatment at the commune level.
- Cases of health insurance medical treatment where the cost for a single treatment is less than 15% of the basic salary (which is currently 1.49 million VND per month).
- Patients who have participated in health insurance for 5 consecutive years or more and have paid an amount equal to or greater than 6 months of the basic salary for medical treatment, except for cases of self-referral.
Tooth extraction with health insurance is 80-95% deductible for the following individuals:
- Those who are eligible for pension benefits, monthly disability benefits, relatives of revolution contributors, those who care for martyrs, and low-income families receive 95% reimbursement for health insurance costs.
- Those who receive 80% reimbursement for health insurance costs if they receive treatment or wisdom tooth extraction within the designated network but do not fall into the above-mentioned groups.
Tooth extraction with health insurance is 40-70% deductible for the following individuals:
- Those who receive 40% reimbursement for health insurance costs for inpatient treatment at central hospitals.
- Those who receive 60% reimbursement for health insurance costs for inpatient treatment at provincial hospitals. However, this has been changed to 100% since January 1, 2021.
- Those who receive 70% reimbursement for health insurance costs for inpatient treatment at district hospitals. However, this has been changed to 100% since January 1, 2016.
The price of tooth extraction with health insurance can vary depending on the individual’s eligibility for reimbursement. Therefore, it is important to determine which group you belong to in order to calculate the exact cost.
For individuals seeking wisdom tooth extraction with health insurance, it is possible to receive reimbursement at most public hospitals. Private hospitals and international hospitals also offer flexible payment options for dental visits and tooth extraction.
When receiving tooth extraction for dental conditions at BeDental, you can not only use health insurance benefits but also enjoy promotions and discounts through payment with participating banks. Additionally, BeDental guarantees a painless and safe extraction procedure with skilled dental professionals and advanced technology.
This article has provided you with all the information about the price of tooth extraction with health insurance and where to get wisdom tooth extraction with health insurance. Hopefully, this useful information will help you determine if your case is eligible for reimbursement. Contact BeDental if you have any further questions.
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