Can dialysis medical insurance be reimbursed?
You can't report it without being hospitalized. However, dialysis is a major disease, which should be treated according to the family ward (hospitalization) or specialist clinic (due to different local regulations). General outpatient service is definitely not allowed to report. Medical insurance for urban workers is 80%-95% (in different places), medical insurance for urban residents is 60%, and the new rural cooperative medical system is 40%.
Proportion of reimbursement for major diseases:
All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or for the whole year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%. The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.
Enjoy medical insurance benefits:
Within one year, the qifubiaozhun for outpatient medical expenses paid according to Class I standard is 50 yuan, and the maximum payment limit of the insured person's outpatient co-ordination fund this year is 900 yuan. The initial reimbursement rate for general outpatient medical expenses between Qifubiaozhun and the maximum payment limit is 30% if it meets the policy requirements.
According to the second standard, there is no deductible for outpatient medical expenses. The maximum payment limit of the insured person's outpatient co-ordination fund this year is 500 yuan, which is in line with the general outpatient co-ordination medical expenses policy, and the initial reimbursement ratio is 25%.
In line with the policy, the general outpatient department will co-ordinate the reimbursement of medical expenses and implement the second compensation method. The proportion of secondary compensation is determined by the municipal human resources and social security department in conjunction with the municipal finance department depending on the fund balance. Degree, urban and rural residents in the contracted medical institutions in line with the provisions of the general outpatient co-ordination policy of medical expenses, the second compensation ratio of not less than 20%.
Can dialysis medical insurance be reimbursed? To sum up, dialysis hospitalization can only be reimbursed, and hospitalization can't be reported, and it should be reimbursed according to family wards or specialist clinics. In addition, the medical expenses of inpatients participating in cooperative medical care can be compensated by 65% according to 500 1- 10000 yuan, and by 70% according to1001-/8000 yuan.
Legal basis:
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.