For the replacement itself the answer is no. But a tooth replacement case usually runs through several steps, and some of them do fall within the scope of health insurance.
- Replacing a lost tooth is outside the scope of health insurance cover, because it is prosthetic work rather than treatment of disease.
- Outside cover: implants, removable dentures, bridges, crowns, denture repairs and relining.
- The disease treatment beforehand, such as removing retained roots, treating periodontal disease or root canal work on a neighbouring tooth, is considered under insurance when prescribed.
- Bring your health insurance card even when the replacement is your main purpose, and ask the dentist to separate the items before starting.
A tooth has been missing for a while and you would like it replaced. The first question for many patients is whether the health insurance card covers any of it. This article answers directly, and points out the part of the cost that many people do not realise is still considered.
The short answer
No. Replacing a lost tooth falls outside the scope of health insurance cover, whether the work is done at a public facility or at a clinic holding a health insurance treatment contract.
The dividing rule is simple: health insurance covers the treatment of disease, not prosthetic or cosmetic work requested by the patient. Tooth replacement is prosthetic work, so it sits outside.
Items outside the scope of cover
- Dental implants and implant-supported dentures.
- Removable partial and complete dentures.
- Bridges, crowns and veneers.
- Repairing a broken denture, relining, adding a tooth or a clasp to a removable denture.
- Removing an existing crown.
This list applies everywhere. It is not one clinic's own policy.
The part that is still considered for cover
Here is the point worth knowing. A tooth replacement case rarely consists only of fitting the new tooth. Existing disease usually has to be dealt with first, and those treatment steps are considered within the scope of health insurance when prescribed by the dentist:
- Examination and diagnosis of oral disease.
- Removing retained roots, teeth loosened by periodontal disease, or teeth that cannot be saved.
- Treating periodontal disease, and scaling where it forms part of prescribed treatment.
- Root canal treatment on a neighbouring tooth where that tooth has pulp disease.
Put simply, clearing the disease is considered under insurance, while rebuilding the missing tooth is paid for privately.
One case, two parts
A common example: a back tooth is decayed and broken beyond saving, and the patient wants it out and replaced. That case has two parts calculated two different ways. Removing the diseased tooth is considered under health insurance. Rebuilding the tooth afterwards, whether by implant or bridge, is paid privately.
At Ky Hoa Dental the dentist separates the two and quotes before starting. Nothing begins until you have agreed.
How to avoid surprises
- Bring your health insurance card or the VssID or VNeID app and your identification, even though your main purpose is the replacement. Only then can the disease treatment be recorded properly.
- Ask the dentist to separate the items clearly: which fall within insurance and which are private.
- Ask about later costs too, such as the prosthetic part on an implant and the follow-up visits.
- Look at the price list beforehand so you have a reference figure.
The level of cover for the eligible part depends on the category recorded on your card under the Law on Health Insurance. A short call to the hotline with your card details in hand gives you a specific answer rather than guesswork.
Ky Hoa Dental is the dental department of Ky Hoa Medical Centre, a general clinic holding a health insurance treatment contract, at 266A - 268, 3 Thang 2 Street, Hoa Hung Ward, Ho Chi Minh City, open Monday to Saturday.
Frequently asked questions
Are dental implants covered by health insurance?
No. Implants and implant-supported dentures are prosthetic replacements for lost teeth and fall outside the scope of health insurance cover. This applies regardless of whether the work is done at a public facility or a clinic holding a health insurance treatment contract.
What about removable dentures or a bridge?
They fall outside cover as well, in the same group as implants. Related work such as repairing a broken denture, relining, or adding a tooth or clasp is also paid privately.
Is removing a retained root before a replacement covered?
Removing retained roots or teeth that cannot be saved is treatment of disease, so it is considered within the scope of health insurance when prescribed by the dentist. Rebuilding the tooth afterwards is private. That is why it is worth bringing your card even when the replacement is your main purpose.