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(Types of Cases and Treatments)
 
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{{עצם העניין}}{{סוג ערך|זכות}}
 
{{עצם העניין}}{{סוג ערך|זכות}}
{{תקציר}}
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{{תקציר |תוכן=
 
{{דגשים  
 
{{דגשים  
 
| מידע  = קופת החולים משתתפת במימון טיפולי שיניים מיוחדים ב-3 מקרים: פגיעה בהתפתחות עצמות הפנים, פגם מולד במשנן ובעלי חיך ושפה שסועים מלידה
 
| מידע  = קופת החולים משתתפת במימון טיפולי שיניים מיוחדים ב-3 מקרים: פגיעה בהתפתחות עצמות הפנים, פגם מולד במשנן ובעלי חיך ושפה שסועים מלידה
  
| מידע = The health plans provide funding towards dental care for 3 special types of patients: those with facial nerve development damage, those with cleidocranial dysplasia, and those with cleft lip and palate from birth
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| מידע = People with specific injuries and disorders are entitled to various dental treatments, based on the terms of eligibilty
 
| איסור = <!-- דוגמה: אסור לעשות -->
 
| איסור = <!-- דוגמה: אסור לעשות -->
| חשוב  = The health fund (''kupat cholim'') also participates in [[Dental Care Funding for Cancer Patients]]
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| חשוב  =  
| פיצוי = <!-- דוגמה: מגיעים לכם X שקלים -->
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| פיצוי = Depending on the case, the treatments are given free of charge or for a deductible fee
 
| שאלה  = <!-- דוגמה: שאלה -->
 
| שאלה  = <!-- דוגמה: שאלה -->
| ממשל  = For more information, see the [http://www.health.gov.il/hozer/mr17_2011.pdf Ministry of Health circular]
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| ממשל  = For more information, see the [http://call.gov.il/infocenter/index?page=answers&startover=y&category=null&question_box_status=changed&question_box=%D7%98%D7%99%D7%A4%D7%95%D7%9C%D7%99+%D7%A9%D7%99%D7%A0%D7%99%D7%99%D7%9D+%D7%9E%D7%99%D7%95%D7%97%D7%93%D7%99%D7%9D Kol HaBriut website]
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}}
 
}}
 
}}
{{תקציר/סיום}}
 
 
{{טפסים
 
{{טפסים
 
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| 1 =  
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}}
 
}}
 
{{עצם העניין/סיום}}
 
{{עצם העניין/סיום}}
 
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In general, dental care is not included in [[The Healthcare Basket]] for people over age 18. However, patients that have specific injuries and disorders should be entitled to various dental treatments, based on the terms of eligibility.
Most dental and periodontal care is not included in the [[The Healthcare Basket]] for youth and adults above a certain age (see [[Free Dental Care for Children]]), except for cases in which the treatment has been medically established to be necessary and life-saving.
 
* In 2010, 3 cases of special patients who are entitled to dental and periodontal care were added to the healthcare basket: those with facial bone developmental damage, those with congenital dental defects, and those with cleft lip and palate from birth.
 
  
 
== Who is Eligible? == <!--מי זכאי-->
 
== Who is Eligible? == <!--מי זכאי-->
 
* Those afflicted with one of the following:
 
* Those afflicted with one of the following:
** Those with facial bone developmental damage
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** Those with facial bone developmental damage (Hemifacial Microsomia)
 
** Those with congenital dental defects of cleidocranial dysplasia
 
** Those with congenital dental defects of cleidocranial dysplasia
 
** Those with cleft lip and palate from birth
 
** Those with cleft lip and palate from birth
 
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**Those with Treacher Collins disorder
 +
**Those born with a significant number of teeth missing.
 +
**Those with congenital structural injury to the structure and material of the tooth.
 +
**Those with a birth defect causing premature closure of the cranial seams (Craniosynostosis)
  
 
== How to Claim It? == <!--תהליך מימוש הזכות-->
 
== How to Claim It? == <!--תהליך מימוש הזכות-->
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== Types of Cases and Treatments ==
 
== Types of Cases and Treatments ==
==Dental Care for Those with Facial Nerve Development Damage==
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===Dental Care for Those with Facial Nerve Development Damage===
 
* Treatment may be provided following diagnosis from a surgical specialist, orthodontist or maxilla-facial surgeon.  
 
* Treatment may be provided following diagnosis from a surgical specialist, orthodontist or maxilla-facial surgeon.  
 
* The basket includes:
 
* The basket includes:
 
** Preservative dental treatment prior to orthodontic treatment
 
** Preservative dental treatment prior to orthodontic treatment
 
** Orthodontic and surgical treatment
 
** Orthodontic and surgical treatment
 
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*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
==Dental Care for Those with Cleidocranial Dysplasia==
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===Dental Care for Those with Cleidocranial Dysplasia===
 
* Treatment may be provided following a diagnosis of the cleidocranial dysplasia genetic defect, from a doctor or dental specialist.
 
* Treatment may be provided following a diagnosis of the cleidocranial dysplasia genetic defect, from a doctor or dental specialist.
 
* The basket includes:
 
* The basket includes:
 
** Preservative dental treatment prior to orthodontic treatment
 
** Preservative dental treatment prior to orthodontic treatment
 
** Orthodontic and surgical treatment
 
** Orthodontic and surgical treatment
 
+
*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
==Dental Care for Those with Cleft Lip and Palate==
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===Dental Care for Those with Cleft Lip and Palate===
 
* Treatment may be provided to patients '''up to age 25''' who were born with a cleft lip and palate, following diagnosis from a doctor or dental specialist.
 
* Treatment may be provided to patients '''up to age 25''' who were born with a cleft lip and palate, following diagnosis from a doctor or dental specialist.
 
* The basket includes:
 
* The basket includes:
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** Pre-rehabilitation surgical treatment in the area of the cleft
 
** Pre-rehabilitation surgical treatment in the area of the cleft
 
** Rehabilitation treatment in the area of the cleft
 
** Rehabilitation treatment in the area of the cleft
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*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
 +
===Patients with Treacher Collins Syndrome===
 +
*These patients are entitled to dental care in the areas of prevention, preservation, orthodontics and oral rehabilitation.
 +
*This right is for patients up to age 30.
 +
*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
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===Patients with a Congenital Absence of Multiple Teeth===
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*The treatment consists of a round of dental treatments that including prevention, preservation, orthodontics and oral rehabilitation.
 +
*Prevention and preservation treatments are for patients up to age 30.
 +
*Patients are eligible to complete the series of orthodontic and rehabilitative treatments until age 40, provided they began the treatment before age 30.
 +
*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
 +
===Patients with a Congenital Structure Disorder in the Structure and Tooth Material===
 +
*Patients who have teeth that are directly affected by Amelogenesis imperfecta or Dentinogenesis imperfecta are entitled to preservative and rehabilitative dental treatments including:
 +
**Check-ups by a specialist and x-rays, as necessary.
 +
**Dental preservation treatments (tooth decay treatments, fillings, extractions, root canal, crowns).
 +
**A round of dental rehabilitation treatment (permanent crowns or bridges).
 +
*Treatments are given to people up to age 25.
 +
*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
 +
===Patients with Premature Closure of Cranial Sutures===
 +
*The treatment consists of a round of dental treatments including prevention, preservation, orthodontics and oral rehabilitation.
 +
*The right is given to patients up to age 40 who have a disorder that causes the premature closure of cranial sutures (such as Pfeiffer, Apart and Crouzon disorders).
 +
*For more information see the [http://call.health.gov.il/infocenter/index?page=content&id=EL4347&actp=search&viewlocale=he_IL&searchid=1550675165905 Kol HaBriut website]
  
 
== Please Note == <!--חשוב לדעת-->
 
== Please Note == <!--חשוב לדעת-->
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* [http://www.maccabi4u.co.il/9520-he/Maccabi.aspx Information for Maccabi policyholders]
 
* [http://www.maccabi4u.co.il/9520-he/Maccabi.aspx Information for Maccabi policyholders]
  
== Sources == <!--מקורות-->
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== Credits == <!--מקורות-->
  
 
* Original information provided by the [[:he:ההסתדרות הרפואית בישראל|IMA]].
 
* Original information provided by the [[:he:ההסתדרות הרפואית בישראל|IMA]].
*Original translation by [[AACI - Association of Americans and Canadians in Israel|AACI]]'s [[The Shira Pransky Project|Shira Pransky Project]].
+
* {{קרדיט/פרויקט שירה פרנסקי}}
<!--כותרת דמה עבור הטמעת כותרת. לא לגעת!
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==Metadata==
==endarticle==
 
כותרת דמה עבור הטמעת כותרת. לא לגעת!-->
 
 
   
 
   
 
<!-- יש לכתוב תגיות כאן בתחתית -->
 
<!-- יש לכתוב תגיות כאן בתחתית -->
 
[[קטגוריה:זכויות]]
 
[[קטגוריה:זכויות]]
 
[[Category:Rights]]
 
[[Category:Rights]]
 
[[he:מימון טיפולי שיניים לחולים מיוחדים]]
 

Latest revision as of 09:21, 29 March 2019

Introduction:

People with specific injuries and disorders are entitled to various dental treatments, based on the terms of eligibilty
Depending on the case, the treatments are given free of charge or for a deductible fee
For more information, see the Kol HaBriut website


In general, dental care is not included in The Healthcare Basket for people over age 18. However, patients that have specific injuries and disorders should be entitled to various dental treatments, based on the terms of eligibility.

Who is Eligible?

  • Those afflicted with one of the following:
    • Those with facial bone developmental damage (Hemifacial Microsomia)
    • Those with congenital dental defects of cleidocranial dysplasia
    • Those with cleft lip and palate from birth
    • Those with Treacher Collins disorder
    • Those born with a significant number of teeth missing.
    • Those with congenital structural injury to the structure and material of the tooth.
    • Those with a birth defect causing premature closure of the cranial seams (Craniosynostosis)

How to Claim It?

  • First, a diagnosis must be performed by a dental specialist.
  • According to the diagnosis the patient is treated by a specialist in these medical conditions.
  • The co-payment amounts vary depending on the type of treatment. Patients should check with their health plan.
  • In order to receive a reimbursement for treatment not performed by the health plan, health plan approval of the treatment must be obtained in advance by submitting a request to the primary care clinic (branch) to which the policyholder belongs.
  • After treatment, policyholders should provide their primary care clinic (branch) with original receipts and invoices. Reimbursements are given up to a pre-determined maximum ceiling. Policyholders should contact their health plan for the most up-to-date ceiling information.

Types of Cases and Treatments

Dental Care for Those with Facial Nerve Development Damage

  • Treatment may be provided following diagnosis from a surgical specialist, orthodontist or maxilla-facial surgeon.
  • The basket includes:
    • Preservative dental treatment prior to orthodontic treatment
    • Orthodontic and surgical treatment
  • For more information see the Kol HaBriut website

Dental Care for Those with Cleidocranial Dysplasia

  • Treatment may be provided following a diagnosis of the cleidocranial dysplasia genetic defect, from a doctor or dental specialist.
  • The basket includes:
    • Preservative dental treatment prior to orthodontic treatment
    • Orthodontic and surgical treatment
  • For more information see the Kol HaBriut website

Dental Care for Those with Cleft Lip and Palate

  • Treatment may be provided to patients up to age 25 who were born with a cleft lip and palate, following diagnosis from a doctor or dental specialist.
  • The basket includes:
    • General preservative treatment
    • Preservative treatment in the area of the cleft
    • Pre-rehabilitation surgical treatment in the area of the cleft
    • Rehabilitation treatment in the area of the cleft
  • For more information see the Kol HaBriut website

Patients with Treacher Collins Syndrome

  • These patients are entitled to dental care in the areas of prevention, preservation, orthodontics and oral rehabilitation.
  • This right is for patients up to age 30.
  • For more information see the Kol HaBriut website

Patients with a Congenital Absence of Multiple Teeth

  • The treatment consists of a round of dental treatments that including prevention, preservation, orthodontics and oral rehabilitation.
  • Prevention and preservation treatments are for patients up to age 30.
  • Patients are eligible to complete the series of orthodontic and rehabilitative treatments until age 40, provided they began the treatment before age 30.
  • For more information see the Kol HaBriut website

Patients with a Congenital Structure Disorder in the Structure and Tooth Material

  • Patients who have teeth that are directly affected by Amelogenesis imperfecta or Dentinogenesis imperfecta are entitled to preservative and rehabilitative dental treatments including:
    • Check-ups by a specialist and x-rays, as necessary.
    • Dental preservation treatments (tooth decay treatments, fillings, extractions, root canal, crowns).
    • A round of dental rehabilitation treatment (permanent crowns or bridges).
  • Treatments are given to people up to age 25.
  • For more information see the Kol HaBriut website

Patients with Premature Closure of Cranial Sutures

  • The treatment consists of a round of dental treatments including prevention, preservation, orthodontics and oral rehabilitation.
  • The right is given to patients up to age 40 who have a disorder that causes the premature closure of cranial sutures (such as Pfeiffer, Apart and Crouzon disorders).
  • For more information see the Kol HaBriut website

Please Note

Aid Organizations

  • For a comprehensive categorized listing of healthcare organizations offering assistance and support, click here.

Government Agencies

Laws and Regulations

Additional Publications

Credits