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Is it possible to have a (specialist) dental prosthesis refunded by the National He alth Fund for a person suffering from drug-resistant epilepsy (medically documented)? If so, what should be done?
Each he alth case, including epilepsy, should be treated individually by the National He alth Fund, and it is the statutory framework or regulations that shape the practice of providing specialist advice and medical assistance.
For this reason, a patient suffering from drug-resistant epilepsy, applying for a reimbursement of a dental prosthesis, may refer to a dentist who has signed a contract with the National He alth Fund for the performance of dental services, including: 1) supplementing missing teeth with a mobile partial denture with the use of bent-on elements that maintain 1 time in 5 years, in the range of 5-8 missing teeth in 1 dental arch (the restriction does not apply to people after surgical tumor removal); 2) supplying the toothless jaw with complete dentures in the mandible / maxilla with taking a functional impression on an individual tray once every 5 years (the restriction does not apply to people after surgical removal of tumors); 3) supplying the toothless jaw with complete dentures in the mandible, including taking a functional impression on an individual tray once every 5 years (the restriction does not apply to people after surgical removal of tumors). The denture can be changed every 5 years.
Legal basis: Regulation of the Minister of He alth on guaranteed services in the field of dental treatment (Journal of Laws of 2009, No. 140, item 1144, as amended)
If the patient proves that with this type of disease he needs more frequent replacement of the dentures, then he should apply directly to the National He alth Fund with a request for reimbursement. On the website www.nfz.gov.pl you can find all the necessary data, including telephone numbers and branches of the National He alth Fund throughout the country, where you can report and present the case.
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Przemysław GogojewiczIndependent legal expert specializing in medical matters.
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