Attachment to the clinic under the compulsory medical insurance policy

Home assistance for people with limited mobility

The provision of dental care at home is carried out within the framework of the order of the Moscow Department of Health dated July 7, 2009 No. 783 “On improving the provision of dental care to disabled people with severe disabilities.” Dental clinics have teams to provide therapeutic and orthopedic care to bedridden patients. To provide medical care at home, a preliminary examination by a local physician is required, followed by the issuance of a report on the general state of health and the possibility of providing assistance at home. Comprehensive dental care at home for disabled people with severe disabilities is provided in accordance with the list of dental services:

Examination of the oral cavity.
Determination of the state of oral hygiene with indication of dental plaque (hygiene index).
Determination of the condition of periodontal tissues and oral mucosa.
Manual removal of dental plaque and recommendations for brushing teeth.
Carrying out atraumatic treatment of dental caries using glass ionomer cements for filling.
Treatment of hyperesthesia of hard dental tissues.
Treatment of pulpitis, periodontitis and periodontal diseases.
Grinding of teeth.
Taking impressions to make partial or complete removable dentures
Correction of prostheses
Removing crowns
Prosthetic repair
Surgical dental care is provided only in outpatient or inpatient settings upon referral from the dental clinic to which the patient is assigned.

Information updated 03/17/2021

Cons of depulpation

Today it is known that unnecessarily depulpation can cause much more harm than good:

After depulpation, the tooth becomes fragile and decays much faster
During depulpation, the nerve may not be completely removed
The dental canal may not be properly cleaned or filled.
During treatment, gums may be injured

That is, a “dead” tooth will never be better than an ordinary healthy tooth that has not been opened. A crown can prolong its life for some time, but the risk of complications after depulpation and rapid tooth destruction is no less than if it were kept intact. That is why many professional dentists prefer to examine the tooth as thoroughly as possible and prepare it for prosthetics, but do not open it or remove the pulp.

Admission under a compulsory health insurance policy (CHI)

Insured citizens of the Russian Federation have the opportunity to receive free medical care in the amount established by the Territorial Compulsory Medical Insurance Program.

The compulsory medical insurance policy is the main document confirming the fact of insurance of a citizen. When visiting the clinic for the first time, you must fill out an application for choosing a medical organization and provide a compulsory medical insurance policy and an identity document.

In 2022, residents of Moscow will be provided with free medical care at the expense of Insurance Fund on the basis of the Territorial Program of State Guarantees for the free provision of medical care to citizens in the city of Moscow for 2022 and for the planning period of 2022 and 2023, approved. Decree of the Moscow Government dated December 30, 2020 N 2401-PP and the tariff agreement between the Moscow Government and the Compulsory Medical Insurance Fund (Appendix No. 6 to the tariff agreement).

LIST OF DENTAL SERVICES INCLUDED IN THE COMPLIANCE PROGRAM:

Therapeutic dentistry and periodontology:

appointment with a dentist-therapist;
treatment of dental caries using domestically produced filling materials in cases of tooth decay of less than 50%;
treatment of pulpitis (inflammation of the nerve of the tooth) using endodontic instruments and filling materials of domestic production;
treatment of periodontitis (inflammation of the tissues surrounding the tooth root) using endodontic instruments and domestically produced filling materials;
removal of dental plaque (tartar above and below the gingiva) manually at once in the area of up to six teeth;
treatment of inflammatory diseases of the oral mucosa and gums (gingivitis, periodontitis, stomatitis) using domestically produced medicines with the exception of surgical treatment methods;
splinting of teeth with domestically produced fast-hardening plastic for complex treatment of periodontal disease;
pain relief during dental treatment using anesthetics and standard disposable syringes of domestic production;
treatment of dental hypersensitivity (hypersensitivity) using domestically produced fluoride-containing preparations;
covering the fissures of one tooth with a domestically produced sealant for the children’s population;
grinding of hard dental tissues.

Surgical dentistry:

appointment with a dentist-surgeon;
simple and complex tooth extraction, including removal of dystopic and impacted teeth (with anomalies in location) for medical reasons;
pain relief during dental treatment using anesthetics and standard disposable syringes of domestic production;
treatment of pericoronitis (excision of the hood) with difficult teething;
treatment of alveolitis (complications after tooth extraction) with curettage of the socket;
treatment of injuries of the maxillofacial area (splinting of teeth in case of fracture);
treatment of inflammatory diseases of the oral cavity: opening of a subperiosteal abscess, soft tissues in the oral cavity;
removal of bony protrusions;
removal of benign neoplasms in the periodontal area and oral mucosa;
treatment of diseases of the salivary glands (diagnosis of the disease, carrying out complex measures aimed at correcting immunity, influencing the pathological process in the salivary gland);
plastic surgery of the frenulum of the upper or lower lip, frenulum of the tongue (persons under 18 years of age).

X-ray diagnostics:

orthopantomography (only for children and privileged categories of the population for the purpose of dental prosthetics);
radiography and radiovisiography - intraoral targeted X-ray photographs of teeth (on film and paper).

Orthodontics:

appointment with an orthodontist;
orthodontic treatment of children (bite correction) with the use of orthodontic plates (no more than two plates per 6 months) using domestic materials;
production of removable dentures replacing teeth (made with domestic materials) for children with primary and secondary adentia;
conducting massage and myogymnastics with training for children and their parents depending on the pathology;
separation, grinding of teeth;
repair of orthodontic plates;
production of protective stamped crowns;
carrying out correction, activation of orthodontic equipment.

In particular, this appendix (Appendix No. 6 to the tariff agreement) at the expense of compulsory health insurance funds provides for the installation of the following types of fillings: – made of cement; – metal-containing; – made of chemically cured composite material.

As follows from this list, the installation of a light seal is not included in the list of medical care provided on an outpatient basis within the framework of the Territorial Compulsory Medical Insurance program in the city of Moscow; accordingly, it can only be carried out on a paid basis.

LIST OF DENTAL SERVICES NOT INCLUDED IN THE COMPLIANCE AND STATE GUARANTEES PROGRAMS

aesthetic restoration of teeth using light-curing materials;
light-curing fillings;
production of veneers using the direct method;
use of intracanal pins (fiberglass, parapulp, etc.);
treatment of root canals of teeth: treatment of root canals using NITI rotating machine instruments, filling of root canals using thermoplastic gutta-percha and imported pastes, removal of foreign bodies from root canals;
intracanal whitening of pulpless (“dead”) teeth;
restoration of the tooth stump under an artificial crown made of imported glass ionomer cement;
treatment of inflammatory periodontal diseases using modern methods using imported materials (directed tissue regeneration, splinting of mobile teeth, cosmetic closure of exposed tooth necks, etc.);
surgical methods for the treatment of periodontal diseases (open curettage, flap surgery, gingivoplasty, etc.);
implantology, operations for guided bone regeneration and plastic surgery of soft tissues in the area of implants;
removal of teeth for orthodontic indications for persons over 18 years of age;
depulpation of teeth under X-ray control in order to prepare teeth for the implant area;
cystotomy;
cystectomy (removal of the root cyst);
prosthetics on implants;
plastic surgery of the frenulum of the upper or lower lip, frenulum of the tongue for persons over 18 years of age;
plastic surgery of scars and cords of the oral mucosa;
plastic surgery for gum recession, including connective tissue grafts from the palate and other oral sources;
resection of the root apex;
hemisection;
vestibuloplasty surgery;
installation of implants;
prosthetics on implants;
correction of lip and tongue frenulum using a diode laser (for children and adults);
carrying out orthopedic and orthodontic treatment for persons over 18 years of age and of working age;
partial and complete removable laminar dentures made from imported material;
clasp dentures of varying degrees of complexity;
fixed dentures (single and bridge dentures: steel, plastic, metal-plastic, metal-ceramic, prostheses made of gold and precious metals) from imported materials;
retreatment of teeth for the purpose of dental prosthetics previously treated in other health care facilities;
unsealing root canals for inlays for the purpose of dental prosthetics;
carrying out orthodontic treatment using fixed appliances, functional appliances and complex orthodontic plates made from imported materials;
anesthesia using imported carpule anesthetics;
general anesthesia (anesthesia) with the use of an anesthetic aid for more than 30 minutes using imported drugs;
treatment and removal of teeth using sedation methods while maintaining consciousness;
prevention of dental diseases: preventive cleaning, removal of dental plaque using an ultrasonic device, removal of age spots, plaque, coating with imported fluoride-containing preparations, deep fluoridation of teeth, teeth whitening;
three-dimensional computed tomography of the maxillofacial region in 3D format, orthopantomography;
orthopantomography of the maxillofacial area for persons over 18 years of age and of working age;
X-ray examination when providing paid medical services and preparing for dentures.

In 2022, you can get more services under the compulsory medical insurance policy

The patient now has the right to choose not only a clinic, but also a federal medical center, which he can go to independently. A referral from a clinic is not required. This is due to a review of their funding. Federal clinics no longer depend on insurance companies and the regional budget, and their only customer is the Federal Compulsory Health Insurance Fund. As a result, citizens who need specialized medical care will be able to receive it faster and at the highest level.

The volume of palliative outpatient medical care has been increased, including within the framework of home visiting, which means that the number of visits by health workers to such patients will increase.

Preventive health care has become more widespread. Starting this year, the medical examination, for example, includes early diagnosis of diabetes mellitus: if the disease is suspected, the therapist will refer the patient to study the level of glycated hemoglobin in the blood. And if he suspects cancer of the mucous membranes or skin, he will prescribe a consultation with a dermatovenerologist, as well as a dermatoscopy.

By the way, in the oncology profile, the volume of medical care in day hospitals increased by 4%, in 24-hour hospitals - by 5.7%. Moreover, the compulsory health insurance system included a revision of histology: rechecking of tissue samples in another laboratory, by other specialists, on other equipment. This is necessary for an accurate diagnosis. Previously, it was possible to obtain a second opinion only at the expense of the patient himself.

Testing for the detection of COVID-19 was also included in the state guarantee program, the cost of which per person will be 584.0 rubles. And in total, per capita standards for medical care provided under the policy (funds provided for one insured person under the compulsory medical insurance program per year) increased from 12,696.9 rubles to 13,531.4 rubles.

At the same time, the temporary standards for the provision of medical care remained the same as last year. Thus, it should be provided immediately in hospitals. The waiting time for an ambulance is 20 minutes, and a therapist must be on call within a maximum of 24 hours. The period from the moment of diagnosis of an oncological disease to the establishment of dispensary observation by an oncologist for a patient with diagnosed oncology is limited to three working days. The waiting time for specialized medical care (except high-tech) may be from 7 to 14 working days if the patient is referred for hospitalization. For patients with cancer, this period is reduced to 7 working days from the moment of histological verification of the tumor or from the moment of establishing a preliminary diagnosis of the disease (condition). The patient should not wait for CT, MRI and angiography when providing primary health care for more than 14 working days from the date of their appointment by the attending physician. In case of suspected cancer, these periods are reduced to 3 working days.