According to the scope of the national basic medical insurance treatment project, the details are as follows:
(1) service items.
(1) Registration fee, out-of-hospital consultation fee, medical record fee, etc.
(2) Special medical services, such as visiting fees, expedited fees for examination and treatment, additional fees for roll-call surgery, high-quality and low-price fees, and self-invited intensive care.
(2) Non-disease treatment projects.
(1) all kinds of beauty and bodybuilding, as well as non-functional plastic surgery and orthopedic surgery;
(2) various weight loss, weight gain and height increase projects;
(3) various health checks;
(4) all kinds of preventive health care and diagnosis projects;
(5) all kinds of medical consultation and medical appraisal.
At present, China has included growth hormone in the medical insurance catalogue. Since 20 17, nine cities including Chuxiong, Lijiang and Xishuangbanna in Yunnan Province have included growth hormone in the scope of medical insurance reimbursement for chronic diseases.
legal ground
According to the Measures for the Implementation of the Basic Medical Insurance for Urban and Rural Residents in Henan Province (Trial)
Thirteenth general outpatient medical treatment. Establish a perfect outpatient co-ordination system. All localities can set up an outpatient co-ordination fund according to about 50% of the local per capita payment, which is mainly used to pay the general outpatient medical expenses (including general medical expenses, the same below) incurred by insured residents in designated medical institutions at the grassroots level.
There is no Qifubiaozhun for outpatient co-ordination, and the reimbursement rate is about 60%. The accumulated reimbursement amount during the year is controlled at about 2 times of the local per capita payment. At present, the conditions for establishing outpatient co-ordination system are not available.
Fourteenth outpatient chronic disease medical treatment. All localities should refer to the original basic medical insurance for urban residents and the relevant policies of the new rural cooperative medical system, and select some diseases (or treatment items) that need long-term or lifelong outpatient treatment and have high medical expenses to be included in the scope of outpatient chronic disease management. There is no Qifubiaozhun for outpatient chronic diseases, and the reimbursement rate is not less than 65%, and fixed-point treatment and quota management are implemented. The specific measures shall be formulated by the municipalities under the jurisdiction of each province.
Article 16 Hospitalization. Insured residents in the designated medical institutions within the scope of the policy of hospitalization medical expenses, Qifubiaozhun below by individuals to pay, Qifubiaozhun above by the hospitalization pooling fund in proportion to pay, the amount does not exceed the annual maximum payment limit of hospitalization pooling fund.
Article 18 Medical treatment for newborns. In the year when the newborn is born, parents who participate in the basic medical insurance automatically obtain the insurance qualification and enjoy the medical insurance benefits for urban and rural residents. If a newborn mother or father participates in the local medical insurance for urban and rural residents, he can enjoy the medical insurance benefits for urban and rural residents in the year of birth with the identity certificate of the mother or father and the medical certificate of birth of the newborn. Parents did not participate in the local medical insurance for urban and rural residents, according to the provisions of the medical insurance agencies for insurance procedures, newborns from the date of birth to enjoy medical insurance benefits for urban and rural residents.
Article 19 The hospitalization medical expenses incurred by insured residents in an insurance year shall be paid by the urban and rural residents' medical insurance fund in accordance with the regulations, and the part of the individual's accumulated compliance medical expenses exceeding a certain amount shall be paid by the urban and rural residents' serious illness insurance and the supplementary insurance fund for the needy people in accordance with the regulations. Specific measures shall be formulated separately.