Organ, bone marrow and prosthetic heart valve candidates for transplants and recipients taking medication to prevent rejection are entitled to dental and periodontal care.
- All policyholders are entitled to dental and periodontal care if it is medically determined to be necessary and life-saving.
- Organ, bone marrow and prosthetic heart valve recipients taking medication to prevent rejection are considered to be a high-risk population for contracting infectious diseases.
- Infections in the oral cavity are liable to be the source of such diseases.
- Prevention of such cases through early detection and removal of potential sources of infection is considered to be necessary and life-saving treatment.
Who is Eligible?
- Patients in any one of the following 3 categories are entitled:
How to Claim It?
- Approval from the health plan (through the patient's primary care clinic) must be obtained before starting treatment.
- Before beginning dental treatment, the patient must get a written medical diagnosis from his/her attending physician including the proposed date of the surgical procedure/transplant.
Basket of Services Before a Transplant or Heart Surgery (for Purposes of Implanting a Prosthetic Heart Valve)
- The basket of services before a transplant or heart surgery (for purposes of implanting a prosthetic heart valve) includes the following preservative treatments:
- Treatment examination and plan including x-rays/visual imaging
- Root canal treatment including restoration
- Extraction of teeth that cannot be preserved
- Removal of tartar and plaque
- Dental restoration and removal of tooth decay
Basket of Services for Two Years Following the Procedure
- The basket of services for the two years following the procedure includes the following treatments:
- First aid if needed
- Periodic check-up every 6 months
- Removal of inflamed tissue and irritants such as tartar and plaque
- Cleanings and instruction on maintaining proper oral hygiene
Laws and Regulations
- The National Health Insurance Law
- Health Administration Circular from 14.02.2010 - Guidelines for dental care of organ transplant and prosthetic heart valve recipients