How to treat teeth for free under the compulsory medical insurance policy

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

Good news: you can get free treatment not only in public clinics, but also in private ones. However, not in all.

All Russian citizens are insured by the Federal Law "On Compulsory Health Insurance in the Russian Federation" in the CHI fund. To use medical services for free, you need to get a compulsory medical insurance policy and attach to the clinic. The policy is issued by an insurance company of your choice, for this you need to have a passport and SNILS with you.

There are basic medical services that can be used throughout the state, and territorial ones, which differ slightly within a particular region. Dental treatment under compulsory medical insurance can also be carried out free of charge Art. 35 p. 6 of Law No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation". The complete list of dental services is regulated by Art. 36 of Law No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation" by the territorial compulsory medical insurance program.

The list of dental services under the CHI program can be found in the table of rates for primary health care specialized dental care in an outpatient setting. For example, on the website of the TF OMS SPB this document can be found in Appendix 14, in the file "Supplementary Agreement No. 1 to the General Tariff Agreement for 2018".

If you decide to treat your teeth with compulsory medical insurance, use this instruction to save time and money.

What kind of dental care can be obtained under the compulsory medical insurance

Free dental services include:

• examination and consultation with a doctor;
• treatment of caries and its complications (pulpitis, periodontitis);
• opening of the periodontal abscess;
• removal of a permanent tooth (simple and complex);
• radiography, orthopantomography;
• removal of dental plaque;
• emergency dental care;
• removal of stuck foreign bodies, primary manipulations in the field of orthodontics;
• trauma care, reduction of dislocated jaw bones.

Free drugs and materials:

• materials for dental filling (domestic preparations);
• anesthesia (lidocaine, novocaine);
• dental composites, silicates and cements;
• expendable materials.

The clinic is obliged to provide you with free pain reliever and use free filling materials. You can also pay for a different type of filling - say, light-cured. But not under duress, but voluntarily: as an alternative option, and not as the only possible one. It's up to you to decide what to use.

You can also brush your teeth, remove tartar according to the compulsory medical insurance policy, but only by hand. You will have to pay for a more pleasant appearance of this procedure, for example, cleaning with ultrasound.

Prosthetics and implantology, installation of braces, treatment of inflammatory periodontal diseases using directed tissue regeneration, restoration of teeth using intracanal pins are paid services.

Not sure if the service you are interested in is free under the compulsory medical insurance policy? Call your insurance company and check.

Is it possible to remove a wisdom tooth under the compulsory medical insurance policy

This is a difficult type of removal, but it is included in the OMC, even if an operation is required. In this case, you have the right to choose another type of anesthesia, and then you will have to pay for it.

If in a dental clinic they demand money from you for the removal of a wisdom tooth, ask why. If for something that “is difficult,” and not for another type of anesthesia, insist on your right to receive the service for free.

If the doctor refuses to remove the tooth for free under the compulsory medical insurance policy, call your insurance company. Insurance representatives are your advocates in conflict situations in clinics. Check with them if you are eligible for free help and what to do if the doctor refuses to provide it.

Important: Emergency dental care - for example, the treatment of acute pulpitis (inflammation of the tooth nerve) or acute periodontitis (inflammation of the tissues surrounding the tooth root) - is provided regardless of the place of attachment. You can call an ambulance at 103, around the clock and free of charge.

How to find out which clinic you can go to

Not sure which dentistry you are attached to? Call your insurance hotline. Its name is indicated on the back of the compulsory medical insurance policy.

Remember that the policy is valid in all regions of the Russian Federation, so it is not necessary to receive medical services at the place of registration. You can also attach to the clinic at the place of temporary residence.

How to treat teeth for free in a private clinic

Free dental care is also available in some private clinics: a number of commercial clinics participate in government programs and cooperate with insurance organizations that reimburse treatment costs under the CHI program. You can see their list in a special register, which contains all polyclinics, hospitals, dispensaries and private centers that are treated free of charge under the policy.

The register of your city can be obtained on the official website of the Territorial Compulsory Health Insurance Fund or by calling the insurance company.

• List of private clinics in Moscow where you can be treated under compulsory medical insurance →
• List of clinics in St. Petersburg →

If you have a compulsory medical insurance policy, you can apply to Art. 16 clause 1 of Law No. 326-FZ "On Compulsory Health Insurance in the Russian Federation" to any clinic that is in the register. That is, if you live in Moscow and are registered in Tambov, this is not a hindrance to going to a private dentistry.

You need to sign up for a private clinic in advance to confirm that you are now its patient. If this is not done, then you will have to pay out of your pocket.

You can attach to a private clinic in the same way as to a regular clinic:

1. Select a clinic from the registry.
2. Call the reception, specify when you can come up for attachment. Sometimes you have to wait, as popular clinics may not be able to cope with the flow of requests.
3. Take your compulsory medical insurance policy and passport with you.
4. After that, you can make an appointment with a doctor.

If you do not like the chosen clinic, you can change it. But you can change the attachment Art. 21 p. 2 No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" only once a year, not counting cases of moving to another city.

Things to Remember

• You have an “advocate” in the person of an insurance company, since it is she who transfers money for treatment and has the right to check the quality of the medical services provided.
• You do not have to go to the dentist in your place of residence: you can find a more suitable clinic for yourself and attach to it.
• To attach to a dental clinic at the wrong address, go to the head of the selected medical institution and take an application form. Fill it out and take it to your insurance company.