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(Types of Cases and Treatments)
 
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{{זכות/תחילת טור ימני}}
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{{עצם העניין}}{{סוג ערך|זכות}}
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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
+
| 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  = <!-- דוגמה: חשוב לדעת -->
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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  = <!-- קישור לגורם ממשל אחראי -->
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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]
}}<!-- פרמטרים סטנדרטיים: מידע/איסור/חשוב/פיצוי/שאלה/ממשל. ראו [[תבנית:דגשים]] למידע על אפשרויות הפרמטרים בתבנית -->
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}}
 
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}}
The health plans provide funding towards dental care for 3 special types of patients: those with facial nerve development damage, those with congenital dental defects, and those with cleft lip and palate from birth.
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{{טפסים
 
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| 1 =
{{זכות/סיום הקדמה}} <!-- תבנית זו דואגת לכך שהכותרת הבאה בתור תתחיל רק מתחת לתוכן העניינים -->
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| 2 =
 
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* Most dental and periodontal care for youth and adults is not included in the [[The Healthcare Basket|healthcare basket]] (the basket only covers [[Free Dental Care for Children|dental care for children]] up to age 12), except for cases in which the treatment has been medically established to be necessary and life-saving.
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}}
* In 2010, 3 cases of special patients who are entitled to dental and periodontal care were included in the healthcare basket:
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{{ראו גם
** Special dental treatments for patients with facial nerve development damage
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| [[Dental Care]]
** Special dental treatments for those with cleidocranial dysplasia
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| [[The Healthcare Basket]]
** Special dental treatments for those with cleft lip and palate from birth
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| [[Health and Illness]]
 +
}}
 +
{{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.
  
 
== Who is Eligible? == <!--מי זכאי-->
 
== Who is Eligible? == <!--מי זכאי-->
* Those found to be eligible for treatment following diagnosis by a dental specialist.
+
* 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? == <!--תהליך מימוש הזכות-->
 
== How to Claim It? == <!--תהליך מימוש הזכות-->
* After a diagnosis has been performed by a relevant specialist, the dental treatments described above are performed by dental specialists with experience treating these specifics types of patients.
+
* First, a diagnosis must be performed by a dental specialist.
* The co-payment amounts vary depending on the type of treatment. Patients should contact their health plan for details.
+
* 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.  
 
* 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 provider their primary care clinic (branch) with original receipts and invoices. Reimbursements are given up to a pre-defined maximum ceiling. Policyholders should contact their health plan for the most up-to-date ceiling information.  
+
* 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 ==
 
== Types of Cases and Treatments ==
==Dental Care for Those with Facial Nerve Development Damage==
+
===Dental Care for Those with Facial Nerve Development Damage===
* Treatment may be provided following diagnosis from a surgical specialist, orthodontist or maxillofacial 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
 
+
*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 diagnosis 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
 +
*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]
 +
===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 [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-->
 
* The health plans provide funding towards treatments of diseases of the mouth.
 
* The health plans provide funding towards treatments of diseases of the mouth.
 
* The health plans also provide [[Dental Care Funding for Cancer Patients|dental care funding for cancer patients]].
 
* The health plans also provide [[Dental Care Funding for Cancer Patients|dental care funding for cancer patients]].
<!--== Legal Precedents ==--> <!--תקדימים משפטיים-->
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<!--== Court Rulings ==--> <!--פסקי דין-->
 
== Aid Organizations == <!--ארגוני סיוע-->
 
== Aid Organizations == <!--ארגוני סיוע-->
 
* For a comprehensive categorized listing of healthcare organizations offering assistance and support, [[Health and Illness/Aid Organizations | click here]].
 
* For a comprehensive categorized listing of healthcare organizations offering assistance and support, [[Health and Illness/Aid Organizations | click here]].
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* [[:he:משרד הבריאות|The Ministry of Health]] - [http://www.health.gov.il/English/MinistryUnits/HealthDivision/MedicalAdministration/Dental/Pages/default.aspx Dental Health Department]
 
* [[:he:משרד הבריאות|The Ministry of Health]] - [http://www.health.gov.il/English/MinistryUnits/HealthDivision/MedicalAdministration/Dental/Pages/default.aspx Dental Health Department]
  
== Laws and Regulations == <!--חוקים ותקנות-->
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== Laws and Regulations == <!--חקיקה ונהלים-->
 +
* [http://www.health.gov.il/hozer/mr17_2011.pdf Medical Administration Circular 17/2011 from 09.05.2011] - Expansion of healthcare services for 2010 - Dental technologies
 
* [[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]]
 
* [[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]]
  
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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-->
+
== Credits == <!--מקורות-->
* [http://www.health.gov.il/hozer/mr17_2011.pdf Medical Administration Circular 17/2011 from 09.05.2011] - Expansion of healthcare services for 2010 - Dental technologies
+
 
 
* 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==
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כותרת דמה עבור הטמעת כותרת. לא לגעת!-->
 
{{זכות/סיום טור ימני}}
 
 
 
{{זכות/תחילת טור שמאלי}}
 
{{זכות/ראו גם
 
| [[Dental Care]]
 
| [[Dental Care Funding for Cancer Patients]]
 
| [[Free Dental Care for Children]]
 
| [[The Healthcare Basket]]
 
| [[Health and Illness]]
 
}}
 
{{זכות/חדשות
 
| 1 =
 
| 2 =
 
| 3 =  
 
}}<!-- עד 3 ידיעות. כל ידיעה מועברת כפרמטר (ממוספר) נפרד. הפורמט המומלץ הוא תאריך מודגש ולאחריו קישור לידיעה. התיבה לא תוצג אם הפרמטרים יישארו ריקים -->
 
{{זכות/טפסים
 
| 1 =  
 
| 2 =  
 
| 3 =  
 
}}<!-- רשימת טפסים למימוש הזכות. כל פרמטר מופיע בשורה משלו, כתבליט (בולט). התיבה לא תוצג אם הפרמטרים יישארו ריקים -->
 
 
 
{{זכות/סיום טור שמאלי}}
 
 
 
 
 
 
<!-- 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