List of dental services included in the compulsory medical insurance system

There is an opinion that treatment at the dentist is always paid for by the citizen. In fact, there are clear obligations of the state to citizens in the field of health care, including the provision of dental care. It is worth noting that free medical dental care is available to absolutely every insured person and it makes no difference which insurance company issued the policy.

Each region of the Russian Federation has its own Territorial Compulsory Health Insurance Program, formed in accordance with the requirements of the unified program of state guarantees.

According to the compulsory medical insurance policy, only emergency medical care is provided throughout the country. The provision of planned medical care is possible only in the insurance territory - in the region of residence.

This means that if a citizen develops a disease of the oral cavity, salivary glands and jaw, he (she) has the right to receive the necessary dental care (in a clinic, hospital) from a medical organization at the district, regional, and, if there are medical indications, at the federal level. free of charge.

How to sign up?

To have your teeth treated for free, you need to go to a dental clinic or the dental department of a hospital, health center...

If a child needs help, then you should contact a children’s dental clinic; often the adult and children’s departments operate within the same clinic.

If inpatient treatment is necessary, it can be completed in the appropriate hospital. Free services under the compulsory medical insurance policy can also be obtained in some private clinics operating in the compulsory medical insurance system.

Just like a regular clinic, you need to be attached to a dentistry. To do this, contact the registry office of the clinic of your choice with your compulsory medical insurance policy and passport. In the future, when applying for dental medical care, it is possible to pre-register for an appointment with a doctor in all available ways: by telephone, in the pre-registration register at a medical organization and, if technically possible, electronic recording using the information and telecommunications network Internet.

Which dentistry is better to choose: one that accepts compulsory medical insurance or a paid one?

When choosing a medical organization, first of all, you should pay attention to the receiving doctor. Before visiting healthcare organizations, you should look at patient reviews.

If you need a simple dental procedure, you can sign up for a free clinic. Here the doctor will look at the problem, conduct a consultation and provide treatment. In the paid version, you will have to pay from 500 to 1000 rubles for one inspection, and then for the work of a specialist and the materials provided.

For complex problems, such as installing braces, you can safely go to a paid organization. Because it won’t be possible to supply them for free in any case.

Terms of assistance

It should be remembered that in accordance with the Territorial Program, when applying for dental care, emergency medical care must be provided immediately; provision of emergency primary health care is no more than 2 hours from the moment of application.

The waiting period for an appointment with local doctors should not exceed 24 hours from the moment the patient contacts the medical organization.

The time frame for consultations with medical specialists when providing primary specialized health care in a planned manner is no more than 14 working days (in Moscow 10 calendar days) from the date the patient contacts the medical organization.

The timing of diagnostic instrumental (radiographic studies, ultrasound studies) and laboratory tests in the provision of primary health care should not exceed 14 working days (in Moscow 10 calendar days) from the date of appointment.

The timing of computed tomography (including single photon emission computed tomography), magnetic resonance imaging and angiography in primary health care should not exceed 14 working days from the date of appointment.

Where can I get dental services?

Dental services under the policy can be obtained in all municipal clinics in the country, as well as in some private institutions. Where can I find clinics that provide free services? This can be done on the website of the insurance company that issued and issued the document to you.

As a rule, the patient is assigned and registered at the medical center near which he lives. If you have a document, you cannot be denied service even if you have a residence permit in one city and live in another.

On a note! Today, many people prefer to join private dentistry, where they cooperate with insurance companies and accept patients under compulsory medical insurance. Why is this more convenient? Private centers have no queues and have the most modern equipment. True, here for such patients the hours and times of appointment may be limited, since doctors only accept patients if they do not have scheduled paid visits.

What happens if you do not have such a policy? In government agencies, regardless of your registration, you will be refused service. True, if the situation is critical and life-threatening, then doctors must still provide emergency assistance.

What dental care is not included in the Territorial Program?

Dental prosthetics is excluded from the program; this type of dental care is paid for from the personal funds of citizens, except for the privileged category of the population, which is financed from the corresponding budget. Unfortunately, there are cases of illegal denial of free dental care under the Territorial Program or you are offered to pay for the specified care.

The insurance company often receives a question: is it possible to install a photopolymer filling under a compulsory medical insurance policy? The fact is that each region has its own Territorial State Guarantee Program, which includes a different range of medical services. In most regions, this type of filling is not included in the list. If there is such a possibility, then the choice of filling material is carried out exclusively by the dentist, with the obligatory informing of the patient about the treatment method.

In Moscow, photopolymer material is not included in the list of services under the compulsory medical insurance policy. Types of filling material: cement, metal-containing filling, filling made of chemically cured composite material.

For more detailed information, you can check with your insurance representative at the contact center number 8-800-200-92-04.

The essence of the procedure

Previously, we found out whether tartar is removed under compulsory medical insurance. Now you need to figure out why this procedure is needed and how it is carried out. Due to poor oral hygiene, for example, when brushing with soft bristles or the patient’s sclerosis regarding mandatory care procedures, soft plaque remains on the surface of the elements of the dentition (here is a list of all the reasons for the formation of tartar). The bacteria that make up plaque actively multiply, especially when food remains remain in the mouth due to insufficient cleaning. The soft plaque grows. Next, the plaque undergoes a mineralization process, turning into a solid substance. Soft deposits harden within one to two weeks. The next stage is transformation into tartar. It can last from two months to six months, depending on additional provoking factors: drinking alcohol, smoking, addiction to carbohydrate foods, general diseases and pathologies of the oral cavity.

The danger of petrified plaque is explained by the fact that the stone is a hotbed of infections and diseases. Affected elements of the dentition can not only be susceptible to other diseases, but also lost. Regular mechanical brushing with a toothbrush will not get rid of the problem. Here, dental calculus removal under the compulsory medical insurance policy will come to the patient’s aid. To identify possible complications and the presence of pathology, we recommend undergoing routine examinations with a dentist once every six months.

The presence of tartar is accompanied by stale breath, the presence of inflammatory processes in the soft tissues of the oral cavity, including the jaw and gums, and the appearance of diseases of the mucous membrane. All the consequences of tartar formation are indicated here. Only a doctor can remove such plaque. There are several methods to fix the problem. Ultrasound is most often used due to its effectiveness and minimal harm to the patient.

It is not possible to remove tartar under the compulsory medical insurance policy in any case. Like any other procedure, there are contraindications:

Presence of infectious diseases of the oral cavity.
Thin enamel of the teeth.
Individual intolerance (allergic reaction to medications used while brushing teeth).
The presence of inflammatory processes in the oral cavity, such as stomatitis. The disease involves damage to the mucous membrane, accompanied by swelling, redness of the mucous membrane, and the formation of ulcers or blisters.
Diseases of the respiratory system that complicate the process of oxygen entering the body.
Untreated damage to dental elements, such as dental caries.

Before you go for a stone removal procedure, you should cure existing diseases of the oral cavity in order to avoid possible unpleasant complications. For example, if you go to the doctor with untreated caries and ignore the warnings, you can significantly worsen the situation and increase the degree of tooth damage. To minimize the patient’s need to use compulsory medical insurance in a dental clinic, we recommend weaning yourself from tobacco, alcohol and overconsumption of sweets, as well as establishing proper oral hygiene.

A minor can also visit the dentist and take advantage of the right to free care. A prerequisite for doctors' assistance in this situation will be the presence of an accompanying adult who is his legal representative (parent, guardian). Children's dental clinics and private centers accept children and adolescents under 18 years of age for dental tartar cleaning. Cleaning can be done no more than once every 6 months for both children and adults. The procedure is also recommended before installing orthodontic structures.

Tags: tartar, compulsory medical insurance policy, tartar removal

About the author: DrZubastik

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What to do?

First, contact the administrator of the medical organization (chief physician, deputy chief physician, head of department) with a request to explain the reason for the refusal or request for payment. In most cases, the problem is resolved on the spot. If the administrator refuses to help, contact your medical insurance company (name, phone number, address, email address is on your compulsory medical insurance policy). Insurance company employees will provide you with the necessary advice and, if necessary, take measures to solve the problem.

Types of dental care

Mandatory expenses

Despite the fact that the above were ways to save money and even get braces for free, a patient who wants to correct his bite still faces mandatory expenses prior to the installation procedure.

First of all, this is payment for the initial consultation of the orthodontist. At the initial consultation, the oral cavity is examined and a treatment strategy is drawn up - the type of bite and problematic dental units whose position needs to be changed are determined.

During the initial consultation, the orthodontist invites the patient to choose a specific type of braces system, taking into account his wishes and financial capabilities, and, if possible, offers alternative treatment methods.

After the doctor has established the need for treatment, the diagnostic stage . An x-ray is taken to better understand the position of the teeth and the structure of the jaws. If necessary, the doctor prescribes a number of other tests (in particular, if the patient has inflammatory processes or other diseases of the oral cavity).

It should be kept in mind that braces can only be installed on healthy teeth.

Therefore, if the patient has carious cavities, inflammation of soft or bone tissue, then all these diseases must first be cured.

Also, based on preliminary diagnosis, the doctor may decide to remove some dental units (for example, if the patient has a small jaw, but large teeth - when correcting the bite in such a situation, some dental units simply will not be able to “fall into place”).

To properly install the system, an impression is taken from the patient’s jaw and a plaster model is made to understand the required angle and force of impact. Immediately before installation, the patient needs to undergo hygienic cleaning of the oral cavity .

During treatment, the patient will also need to visit the doctor several times to adjust the teeth alignment process and prevent possible complications.

When using self-ligating braces, such visits occur a little less often, and with ligature braces - a little more often.

Objective reviews about braces and the consequences of wearing them.

In this publication we will talk about the indications for the installation of orthoimplants.

Follow the link https://orto-info.ru/sistemyi-vyiravnivaniya-zubov/breketyi/kak-privyiknut-sovetyi.html if you are interested in what the period of getting used to braces depends on.

Orthodontics:

Specialized (dental) medical care is provided to children in the treatment of dental pathology using removable equipment (orthodontic plates) using domestic materials, with the exception of the brace system
The waiting period in an outpatient setting is no more than 14 working days (in Moscow 10 calendar days)
Indications: correction of congenital dental pathologies (bite correction) in children

Nuances of saving

There are some principles that will allow the patient to save some money on installing braces:

Search for dental clinics that have only recently started operating.
Such centers, as a rule, organize various promotions, provide free diagnostics, and also offer their first customers a discount card. This policy allows newly opened clinics to quickly gain a client base.
Another way is to look for advertisements for promotions and coupons.
If the patient has a particular clinic in mind, you can follow them on social networks. They usually publish the latest information about discounts, as well as partner promotions.
It is also worth keeping in mind that saving means choosing cheaper materials.
Regarding braces, it will cost significantly less to install models made of non-precious alloys than samples made of titanium, sapphire or ceramics.
The type of braces also significantly affects the final cost of treatment.
Vestibular models, which we are used to thinking of when we hear the word “braces,” will cost the patient much less than lingual models, which are worn hidden, since they are located on the lingual part of the dentition.

Possibility of minimal costs

People who have set out to have straight teeth should know a few more nuances that relate mainly to private clinics.

They also give you the opportunity to get braces for free. Such cases include:

Carrying out promotions . Often clinics (especially newly opened ones) hold various advertised promotions for their services to increase their client base. The conditions for their implementation are different, including completely free installation of braces.
Trial batch for a specific clinic. This is the case when a certain type of brace systems has already been tested in use, but is unfamiliar to this institution.
To determine their characteristics and effectiveness, the clinic (by agreement with the manufacturer) conducts a series of trial procedures free of charge for the client.
Bonus systems. Many private clinics, wanting to “attach” regular clients to themselves, are developing various bonus programs.
As a rule, they have a cumulative principle. Namely: when the payment for the services of this clinic reaches a certain amount, free installation of braces is a bonus for the patient.
Testing a new type of brace systems for yourself. This option is quite rare. Typically, all manufacturers supply already tested models to medical institutions.

But rare cases of such deliveries can still be found. Then the patient receives the brace system free of charge, as a fee for the work performed by the tester.

Attention! The patient must be clearly aware of the consequences of such a step. By agreeing to test an unfamiliar design or materials, he is taking a certain risk.

Of course, identifying opportunities to obtain inexpensive braces requires certain costs (time and effort). But the game is worth the candle - in the end the patient will have straight teeth, received for free.

How to save on treatment: What experts say

Patients wait so long to go to the dentist that it only gets worse. And all because they don’t want to spend large sums of money on treatment. But it’s logical to assume that the faster you solve the problem, the less money you’ll spend later.

Dentists don't understand why patients think that if they start the problem, they can still save money later. How? If the problem is so advanced that you even have to remove several teeth, then you will have to insert implants. It definitely won’t be cheaper than timely dental treatment.

Unfortunately, our people are accustomed to going to the dentist when there is simply no other choice. For example, a tooth hurts terribly, or something even worse...

Therefore, experts advise undergoing treatment on time. It is necessary to undergo a preventive examination at least once a year to prevent serious problems. It is better, of course, to go to the dentist once every six months according to all the rules.

Thus, timely detection of caries at the initial stage will allow you to save almost a fortune. Preventing this disease is twenty times cheaper than treating it!

conclusions

The possibility of free installation of a braces system, or a significant reduction in its cost, can turn the head of any patient. But here it is important to remember the main goal of the upcoming event - beautiful, healthy teeth for the coming years.

The priority should be the safety and reliability of the system, its effectiveness during the treatment process and beyond, and of course, the experience and professionalism of the attending physician. It is not uncommon for failure to follow these fundamental rules to lead to more serious problems.

As popular wisdom says, a stingy person pays twice.

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How to keep your teeth healthy

There is a list of what not to do if you want to have healthy and strong teeth:

Snack less, so you provide food for bacteria. It is necessary to brush your teeth or rinse your mouth after every meal.
Do not eat chewy sweets and chewing gum - they provoke tooth decay.
Don't go overboard on sugar; it's better to snack on some fruit.
At least reduce the number of cigarettes you smoke if you cannot quit smoking. Smoking not only harms your gums and makes your teeth yellow, but worse, it can cause cancer of the lips and oral cavity.
Consume less sugary soda and packaged juices. There is too much sugar, and this is an excellent environment for the development of bacteria.

How to attach to a specific clinic

As mentioned above, admission under compulsory medical insurance is provided by any public dentistry. If you have chosen an institution where you want to undergo treatment, you must register there. To do this, you need to come directly to the clinic with a list of documents: insurance policy, passport or birth certificate of the child (if you need to register the child), SNILS.

The dentist will also ask you to write an application for registration and consent to medical intervention, after which they will create an individual card for you - from now on you have the right to receive the entire list of free services.

The reality of free installation

It should be noted right away that the list of compulsory medical insurance services today does not include such a procedure as straightening teeth using braces.

This rule applies to most medical policy holders. For them, the desire to have a beautiful smile must be paid for independently.

However, there are still a few exceptions here. There are certain groups of citizens who can count on benefits or completely free installation of braces.

First of all, they are the category of children in difficult life situations, namely:

Children without parental care (orphans).
Children with congenital maxillofacial pathologies.
Children with disabilities.
Families with low material income can count on government assistance in paying for such a service for a child.

For adults , there are also options for free braces installation. These options could be:

Work at an enterprise under an employment contract, one of the clauses of which is reimbursement for dental and orthodontic services.
If a person’s activities involve constant public contacts, and his appearance directly or indirectly affects the result of his work.
In this case, the employer can pay for the elimination of such a deficiency. But to receive such a bonus, a person must be sure that he is a valuable employee.
When the need to install a brace system arose as a result of incorrect actions or failure to provide assistance to the patient on the part of the clinic staff.

Important! It is recommended to resolve this situation peacefully, through dialogue with the management of the medical institution. If this is not possible, then the main weapon for the injured patient will be only an appropriate court decision. In other words, the fact of medical error must be proven in court.

Also, people with disabilities and receiving state disability benefits have a chance to receive a similar procedure for free.
Pensioners who have earned the minimum pension can try to get braces installed for free. The condition for this possibility must be medical indications for the need for its installation (for example, gastrointestinal diseases).

To use one of these options, first of all, it is worth studying the legal side of the issue . A qualified lawyer will help you take into account the nuances and avoid making mistakes.

It will also require a lot of effort and attention on the part of the patient. Any document (reflecting his physical condition, financial and marital status, or another) can be decisive.

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Go here to see photos of buccal tubes and learn about their purpose.

At this address https://www.vash-dentist.ru/ortodontiya/breketyi/vestibulyarnyie/rezinki-dlya-vidyi-rekomendatsii-po-ispolzovaniyu.html we’ll talk about the essence of using elastic bands for braces.

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How can we optimize the system of free dental treatment?

In some countries, for example in Germany and the United States, there is a very correct solution. Preventive measures have been introduced there. If you fail to attend such an appointment once, the person will lose the opportunity to undergo treatment under insurance, that is, he will have to pay for the treatment out of his own pocket.

This practice gives, if not one hundred percent, then quite an impressive effect. Experts believe that it would be a good idea to introduce such a system in the Russian Federation, thus optimizing state costs for free dentistry under compulsory medical insurance.

According to statistics, about seventy percent of compulsory medical insurance funding is spent on treating the consequences of caries. If he had been treated on time, this money could have gone to someone else, for example, for prosthetics.

Insurance companies are very economical

Insurance companies often pay clinics on a deferred basis. At the same time, they do not pay for individual manipulations if it goes even slightly beyond the very narrow standards required. But this is still beneficial for clinics, although often an entire department is busy analyzing insurance claims.

It is very important for the clinic to bring a new client so that he feels that he will feel good there and that the doctors are professionals. Conventionally, the insurance company will cover two cleanings, and he will cover another one in addition to the coverage, if necessary.

At the same time, doctors always try to clarify in advance what will be included in the insurance and what will not, so that the patient does not get nervous. Unfortunately, this is not always possible, since during the treatment of caries it may turn out that it is no longer caries, but very much pulpitis. Then either the clinic has to perform some manipulations at a loss, or ask the patient to pay the required amount. There is another very important point: the insurance company may not pay for the level of treatment accepted in the clinic. For example, we believe that treatment without a rubber dam is simply unacceptable from the point of view of asepsis and isolation of the surgical field. This is important to reduce the risk of infection. The insurance company may not cover it. Doctors again have to either ask the patient to pay extra or worsen the quality of treatment in order to meet the requirements of the insurance company. Clinics that focus on accepting patients under VHI are ultimately forced to save significantly on the most complex and top-of-the-line things like microscopes.