Moscow, 05/26/2021, 16:02:58, editorial office PRONEDRA.RU, author Natalya Yazan.
In the Russian Federation, all children, as well as adults, can receive free medical care in orthodontics under compulsory medical insurance. But when going to the dentist with your child, you need to take into account some differences in the procedure for contacting a pediatric orthodontist.
In order for a child to receive help for free, you need to take into account that in addition to having a compulsory medical insurance policy, parents need:
- Have your child’s birth certificate with you;
- You must have your passport.
In addition, the presence of parents is also their responsibility when visiting the dentist. But as an exception, in case of acute unbearable pain, these documents may not be required.
To prevent parents from being taken by surprise by contacting an orthodontist after a change of place of residence, it is best to visit a nearby clinic immediately after moving to a new apartment and, by writing a corresponding application on a special form at the reception desk, “attach” your child to dentistry. Only after this can you count on full service under compulsory medical insurance.
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.
Are there any benefits of compulsory medical insurance treatment for children?
Free pediatric dentistry under compulsory medical insurance is available to everyone. In this case, you can count on the following:
- the doctor will accept and perform a dental examination;
- eliminates the inflammatory process;
- will place a dental filling;
- removes plaque;
- will do splinting;
- cure diseases of the salivary glands;
- remove the tooth;
- will place the plate;
- will do an x-ray.
The advantage of treatment is that it is possible to cure dental diseases for free. However, such services include the most basic treatment options. You will have to pay for using imported materials.
Free dental treatment under compulsory medical insurance can also be of high quality.
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 form is no more than 14 (in Moscow 10) working days from the date the patient contacts a 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 (in Moscow 10) working days from the date of appointment. The timing of computed tomography (including single-photon emission computed tomography), magnetic resonance imaging and angiography in the provision of primary health care should not exceed 30 (in Moscow 26) working days from the date of appointment.
What to do before your appointment
To make a visit to the dentist effective and comfortable for children, it is necessary to prepare for it.
To do this, it is important to know a few simple rules:
- prepare the baby (each mother has her own ways of calming her child);
- for peace of mind, the child can take his favorite toy with him;
- choose a convenient time to visit a specialist;
- prepare documents;
- be sure to feed the child (the body tolerates painkillers more easily, and salivation becomes less);
- brush your teeth;
- take the necessary items, for example, wet wipes, a bottle of water, etc.
In addition, visiting a doctor is not recommended for acute respiratory viral infections, runny nose or exacerbation of chronic diseases. The child must be healthy and as calm as possible.
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. In the Moscow region there is such an opportunity, but the choice of filling material is carried out exclusively by the dentist, with the obligatory informing of the patient about the treatment method. The choice of treatment method using materials from photopolymers is possible in the absence of contraindications (the presence of gum inflammation, the area of the tooth affected by caries, allergic reactions, etc.).
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.
Are light seals included in the compulsory medical insurance system?
In 2021, for Russians with an insurance policy, all consumables that the dentist uses during treatment are provided free of charge. Fillings also belong to them, but we are talking only about the domestic composition. The cheapest is cement: strong, accessible to everyone. Less often, clinics offer composites.
A light-curing filling is an expensive pleasure. Whether a specific institution can provide it under compulsory medical insurance, check before starting treatment. Officially, it must be done; this is stated in the Methodological Recommendations on methods of paying for medical care using compulsory health insurance funds (Appendix 7). Only due to a lack of state budget there is little material, a light filling is placed on the front tooth and only if there is evidence.
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What you have to pay extra for
Each region has its own insurance program, so the provision of some services may require a fee. Thus, a domestic light filling will not cost the patient anything under compulsory medical insurance, but he will have to pay the clinic for anesthesia or other consumables. If the material is imported, it is often paid, the price starts from 800 rubles. and reaches 2000-3000 rubles.
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: no more than two plates per 6 months) using domestic materials, with the exception of the brace system
- Waiting time in outpatient settings is no more than 14 working 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.
How to find out a list of clinics accepting children under compulsory medical insurance in your city
Of course, the easiest option is to create a search query on the Internet. The system will provide the necessary information with contact details of clinics. By calling the number, you can find out with certainty whether dental treatment is provided under the compulsory medical insurance policy, and also make an appointment.
The government services website shows the attached medical organization according to the residential address. To do this, you need to go to your personal account and create a request (section “My Health” - “Information about the attached medical organization”). The system will show a list of clinics.
An insurance company support specialist will explain where to go for free pediatric dentistry services under compulsory medical insurance. The telephone number is indicated on the policy.
In addition, neighbors or mothers on the playground will probably tell you where the child can get help with dental treatment. All you have to do is call the clinic and make an appointment with a doctor.
Dental services for children under the compulsory medical insurance policy: the infographic shows what you can count on.
Are fillings different?
In most cases, doctors in public clinics place fillings from simple cement mixtures. They are of good quality, durable and low cost. At the same time, they contain toxic substances. That's why many people choose paid materials.
The difference between paid and free fillings is quality. In the production of the former, modern high-quality materials are used, which have a long service life and do not create discomfort in the oral cavity. It is not necessary to install an expensive filling; you can choose a budget option among them. At that time, free ones are gradually erased.
During treatment, the specialist will offer several filling options. Among them, you can choose the option that suits the patient in terms of quality and cost.
Important! A seal supplied under a compulsory medical insurance policy has a 1-year warranty.
Advantages of dental treatment in a private clinic under the compulsory medical insurance policy
High level of service
To receive dental services in our clinic, you do not have to wait in tiresome queues for an appointment. You can make an appointment at a convenient time or receive treatment on the same day. An individual approach and attentive attitude are guaranteed to you.
Qualified dentists and modern equipment
Our clinic employs specialists with extensive experience in all areas of dentistry, who constantly improve their level and professional knowledge. Innovative treatment methods and modern equipment allow dental procedures to be performed quickly, painlessly, and with a guarantee.
Convenient location and work schedule
Our clinics are conveniently located in several districts of Moscow near metro stations. You can choose the clinic closest to you and get there by any means of transport. All dental centers are open seven days a week, from 9-00 to 20-00.
Dental treatment according to VHI
Money
Voluntary health insurance (VHI) is a policy that gives the owner the right to receive medical services in private clinics, provided that the person has chosen the desired tariff from the insurance company and paid for it in advance. Of course, the most common way to get such a policy is as an additional bonus from your employer. In this case, the employer pays your contributions to both the compulsory medical insurance fund and the insurance company for VHI, and it already covers the costs of private clinics for your treatment. Each insurance company works with its own list of medical institutions, so you need to immediately clarify it by purchasing a policy yourself or receiving it at work. A voluntary health insurance policy can be basic or extended. For example, not all VHI policies include dental services, but they can be purchased in addition. The range of tariffs here is very large and depends on the insurance company. When a person with VHI has a toothache, he does not immediately go to the clinic. The first thing he does is call the insurance company and describe the symptoms to the doctor on duty. Based on the complaints, the dispatcher draws up an approximate picture of the disease and chooses which specialist to refer the patient to. If there are no special restrictions, the dispatcher takes into account your wishes - closer to home, closer to work, and so on. In order to receive further treatment under insurance after the initial appointment, you need to be given the correct diagnosis, and the doctor and the clinic have a financial interest in further caring for the patient. However, there is a nuance with VHI - sometimes the doctor is interested in selling services under VHI, and sometimes - private services of the clinic. The fact is that there are several types of insurance. The first type, attachment, involves a one-time visit, often with acute pain. They will not leave you to suffer, they will help you, but if the problem requires long-term treatment, insurance will not cover it. The second type of insurance is factual. In this type of insurance, treatment is agreed upon in advance with the clinic and the insurance company.
Naturally, it is more interesting to accept such patients, from whom we receive money every time
The attachment amounts, based on the VHI tariff, vary. On average, the clinic will receive from 800 rubles to 5 thousand rubles for a one-time patient.
Let’s say, according to the clinic’s price list, treating caries on average costs around 5 thousand rubles. And a patient, for example, has a thousand allocated for treatment under VHI. What interest do I have in treating his caries? Accordingly, I can lie to the patient, say, “You don’t just have caries here, you have caries with a large degree of tooth destruction and this is not an insured event, but you can treat it for a fee, I can even give you a discount since you came under the insurance program.” to still retain the patient
When coming for dental treatment under VHI, the patient cannot know for sure whether he will be treated completely free of charge, whether insurance will partially cover the treatment, or whether the doctor will try to impose additional services. It's always a gamble. And the insurance company can't verify who is right—they have to trust the doctor who examines you. Because the doctor is close to you, but the insurance manager is far away.
Quality
The patient may feel that VHI provides better quality treatment than compulsory medical insurance, since the employer or you personally contributed additional money to obtain insurance for yourself. It's a convenient idea, but it's often not true.
The VHI system does not bring much money to doctors, but it does bring money to clinic owners. Clinic owners do not want to invest in treatment under VHI and often purchase the cheapest materials for treatment through insurance.
According to Maria, it often turns out that in the same clinic, fillings that are provided for paid treatment are of better quality than fillings for those treated under VHI. It all depends on the greed of the particular owner of the clinic.
At one of my places of work, we had the same material for filling canals both for compulsory medical insurance and for payers. No expense was spared on materials. And at the same time, that material was of higher quality than when I worked in another private clinic and was treated under VHI and for a fee.
Some services, like taking pictures or brushing your teeth, can be safely done under VHI, because few consumables are needed, and it’s difficult for a specialist to save money on you and ruin something. In other cases, for quality treatment you need to be willing to pay extra.
If you want to receive high-quality treatment under the VHI system, you should prepare for financial investments, since insurance will not be able to cover the entire cost of the doctors’ work and materials. Moreover, it is better to immediately indicate your position to the doctor: say that you are interested in the best result and are ready to pay extra for this. This will make things easier for everyone.
What is included in VHI
Standard dental insurance rarely covers quality care. You have to pay for expensive treatment or materials. Before you take out dental insurance, you should consult with an insurance agent to find out what is included in the VHI, what options can be purchased. You need to decide which services are the most important and why you should take out a policy.
The following dental services are available to individuals with insurance:
- consultation with the attending physician (dentist therapist, surgeon, orthodontist and others);
- diagnostic procedures;
- therapeutic dentistry (treatment of caries, pulpitis, periodontal disease and other diseases of the gums or oral cavity, removal of nerves, placement of fillings);
- cleansing enamel from stones and plaque;
- coating with fluorine-containing varnishes;
- surgical procedures (opening abscesses, removing teeth, dissecting soft tissues);
- traumatological dentistry (reduction of the jaw).
All these services are covered by the standard health insurance program. If this is not enough for the insured, he can purchase an extended plan.
The installation of light fillings, which are durable, as well as dental prosthetics and implantology are very popular among patients. These options can only be included in the program after an additional payment. However, insurance companies often do not tell clients about this opportunity, so as not to remain at a loss.
Related article: Refund of tax deduction for VHI policy
That is why those insured under VHI, when visiting a clinic, have to pay out of pocket for the following treatment:
- hardware removal of tartar;
- aesthetic dentistry (decoration with rhinestones, whitening);
- replacement of conventional fillings with light or other ones without the testimony of the attending physician;
- dental implantation;
- alignment of teeth using braces;
- dental prosthetics.
But even those who managed to insure their teeth under an extended program sometimes have to pay. We are talking about prosthetics. If a tooth has decayed due to the patient’s age, caries, or other natural reasons, then installation of a prosthesis is paid. This case is not covered by insurance.
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.
