Three patterns in which orthodontics is covered by insurance

Last updated April 30, 2022

Patient.

I heard that orthodontic treatment is covered by insurance, is this true?

dentist

Severe cases with abnormal bite due to disease or failure of three or more permanent front teeth to eruptHa,Covered by insurance at medical institutions designated by the Ministry of Health, Labor and Welfare and with the use of orthodontic devicesIt is possible that this could be the case.

Patient.

So if I want orthodontics to fix my appearance at my favorite dentist's office, do I have to pay for it myself?

dentist

Basically, it does. But even if the purpose is to improve the appearance of the patient, insurance may be available if you have an examination at a designated medical institution.

This time,Here are three patterns in which orthodontics is covered by insuranceOh my god!!!

Three patterns in which orthodontics is covered by insurance

There are three patterns in which orthodontics is covered by insurance

Cases of jaw deformities requiring orthodontic and jaw cutting surgery to correct the bite.

The treatment of jaw deformities (*1) is basically

(1) Preoperative orthodontics or bracket and surgical wire installation

(2) Surgery to cut the jawbone

(iii) Postoperative correction

Orthodontic treatment is essential for the treatment of jaw deformities because it is a three-step process.

Therefore,When the cause of bucktooth, arch, open bite, etc. is due to jaw deformity and requires surgery to cut the jawbone and orthodontic treatment before and after the surgery to correct the problem.is covered by insurance.

*1: Jaw deformity is a condition in which there are problems with the shape, size, and position of the upper and lower jaw bones, resulting in abnormal bite and facial deformity. Since the jaw bones are the cause of the misaligned teeth and bite, it is sometimes possible to predict what kind of malocclusion is present just by looking at the shape of the face.

Dentist's Commentary] To Avoid Regrets in Jaw Deformity Treatment! Explains the cost, length of hospital stay, and flow of treatment! - 365 Dentist

For example... If the lower jawbone is enlarged, the patient will have a passive mouth, which is called mandibular prognathism. If the upper jawbone is enlarged, the teeth protrude, which is called maxillary prognathism. There may be a left-right difference in the jaw and the entire face may be distorted. Jaw deformities can be caused by a variety of factors.

365dentist.com

Cases in which three or more permanent front teeth have not erupted and require surgical procedures to correct the bite

A condition in which permanent teeth remain embedded in the gums and do not erupt in adulthood is called "permanent tooth eruption failure.Cases in which there is an abnormal bite due to permanent tooth eruption failure in three or more anterior teeth, and gum cutting surgery (open incisor surgery) is required to erupt the permanent teeth.is covered by insurance.

Cases of abnormal bite due to diseases specified by the Minister of Health, Labor and Welfare

When there is an abnormal bite due to 59 diseases (*2) specified by the Minister of Health, Labor and Welfareare covered by insurance. Both are covered for diseases that may interfere with the bite, as one of the symptoms is reported to be abnormalities in the number of teeth or bone development of the jaw.

*2: The diseases covered may be subject to change as a result of revisions.

59 diseases specified by the Minister of Health, Labour and Welfare

• cleft lip and palate
• Goldenhar syndrome (including gill arch anomalies)
• clavicocranial dysplasia
• Tricia Collins syndrome
• Pierre-Loban syndrome
• Down's syndrome
• Russell-Silver syndrome
• Turner's syndrome
• Beckwith-Wiedemann syndrome
• hemiatrophy of the face
• congenital myopathy
• muscular dystrophy
• spinal muscular atrophy
• hemifacial hypertrophy of the face
• Ellis-Van Cleveld syndrome
• achondroplasia
• ectodermal dysplasia
• neurofibromatosis
• basal cell nevus syndrome
• Noonan syndrome
• Marfan's syndrome
• Prader-Willi syndrome
• Facial clefts (including transverse, oblique and median facial clefts)
• marble bone disease
• melanosis
• Oral, facial, and phalangeal syndromes
• Moebius syndrome
• kabuki syndrome
• Klippel-Trenaunay-Weber syndrome
• Williams' syndrome
• Binder's syndrome
• Stickler's syndrome
• velophthalmia
• Craniosynostosis (including Crouzon's syndrome and acral synostosis)
• osteogenesis imperfecta
• Freeman-Sheldon syndrome
• Rubinstein-Tibi syndrome
• chromosomal deletion syndrome
• Larsen's syndrome
• osteoarthritis pigmentosa
• Congenital partial edentulism of 6 or more teeth
• CHARGE syndrome
• Marshall syndrome
• growth hormone deficiency short stature
• Poly-X syndrome (including XXX syndrome, XXXX syndrome and XXXX syndrome).
• Ring 18 syndrome
• lymphangioma
• global anterior encephalopathy
• Klinefelter's syndrome
• pseudohypoaldosteronism
• Sotos syndrome
• Glycosaminoglycan metabolism disorder (mucopolysaccharidosis)
• fibrodysplasia ossificans
• Sturge-Weber syndrome
• cherubism
• pseudohypoparathyroidism
• Ekman-Westborg-Julin syndrome
• autosomal duplication syndrome
• Other congenital anomalies of jaw and oral cavity(*)

Other congenital anomalies of the jaw and oral cavity" refers to congenital diseases with malformation or deformation of the jaw and oral cavity, and when the need for orthodontic treatment is recognized for malocclusion caused by such diseases, the patient may be subject to orthodontic treatment after consultation with the authorities on a case-by-case basis.

Source: The Japanese Orthodontic Association, "When orthodontic treatment is covered by insurance.
https://www.jos.gr.jp/facility

Other conditions for insurance coverage

Even if it falls under a pattern that can be corrected by insurance coverage,Not all dentists are able to provide treatment covered by insurance.

There are two conditions for medical institutions and orthodontic devices that can be used for orthodontic treatment covered by insurance

Must be a medical institution designated by the Ministry of Health, Labor and Welfare

Dental clinics that offer orthodontic treatment covered by insurance must meet the facility standards approved by the Minister of Health, Labor and Welfare. Therefore, if you want to have orthodontic treatment covered by insurance,The patient must be examined by a dentist licensed to perform orthodontics as an insured health care provider.

Be aware that if you ask a dentist who is not an insured health care provider if insurance is accepted, he or she will not be able to determine if insurance is accepted.

How to find a dentist who can provide orthodontics covered by insurance

Dental clinics where orthodontic treatment is covered by insurance can be found on the website of the local health and welfare (branch) bureau.

(1) HP of the Regional Health and Welfare Bureauhttps://kouseikyoku.mhlw.go.jp/to go to the page for the area where you live or where you plan to do the correction.

Enter "List of Medical Institutions Accepted for Notification of Facility Standards" in the site search box on each page, and click on the "Dental" button.PDF of "List of Medical Institutions Accepted for NotificationSearch for the (*3)

(3) After opening the PDF file, enter "jaw diagnosis" or "orthodontic diagnosis" in the device's in-page search (*4).
Jaw examination and orthodontic examination are terms used to bill insurance points for orthodontic treatment.
If you would like to be examined for jaw deformities, please visit the "Jaw Examination" page., ,If you are considering treatment of malocclusion due to maleruption of three or more anterior teeth or disease, "Orthodontic Diagnosis".Search for a dental office marked with

3: The format and name of the PDF file differs slightly depending on the regional health and welfare bureaus.
4: "Ctrl + F" for Windows, "⌘ command + F" for Mac

Must be orthodontic on the front side

Insurance treatment, whether medical or dental, is intended to provide sufficient and minimal treatment.

Therefore, there are restrictions on the orthodontic appliances used,A type of orthodontic appliance (direct bonding brackets) is supposed to be used, in which brackets are attached directly to the teeth.

Brackets for direct bonding fall into this category because it is a "surface orthodontic treatment" in which the wire is worn on the front side of the teeth,Lingual braces and mouthpiece braces, in which wires are worn behind the teeth, are not covered by insurance.

When orthodontia is not covered by insurance, a medical expense deduction is available.

Although the full cost of orthodontic treatment for patients who do not fall under the pattern of insurance coverage or who wish to have lingual or mouthpiece orthodontic treatment is to be borne by the patient,The medical expense deduction can be used to reduce the actual cost of orthodontic care.

The medical expense deduction is a system that allows a reduction of treatment expenses in the form of an income tax refund and an inhabitant tax reduction when annual treatment expenses exceed 100,000 yen.

If the goal of orthodontic treatment is to improve chewing and pronunciation functions, take advantage of the medical deductible.

Want to know about the Orthodontic Medical Expense Deduction - 365 Dentist

Table of Contents Deducting Medical Expenses for Orthodontic TreatmentWhat is a "medical expense deduction" anyway? Is orthodontic treatment eligible for the medical expense deduction? How much will I get back as a tax refund for medical expense deduction for orthodontic treatment? The amount of refund (the actual amount you will get back) depends on your income.

365dentist.com

Check to see if your teeth can be corrected by insurance!

Correction can be expensive, costing from 700,000 to 1.5 million yen. In some cases, the correction can be covered by insurance,If you are concerned, check with a dental clinic designated by the Ministry of Health, Labor and Welfare that offers "jaw examinations" and "orthodontic examinations".

In 365dentist,

• Assistance in choosing a dentist if you are considering orthodontics.
• Distribution of useful information on insurance coverage and medical expense deductibles
• Dentist-run open chat for orthodontic concerns

and others. Please take a peek if you are interested!

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