The examination and treatment items carried out by large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus are not included in the reimbursement scope of the basic medical insurance pooling fund.
The funds in the personal account are used to pay for the out-of-pocket part of medical treatment and medicine purchase. Including outpatient expenses or hospitalization expenses, personal medical expenses and health examination expenses incurred by designated medical institutions; Expenditure on drug purchase in designated retail pharmacies.
In the basic medical expenses for specific items of hospitalization and outpatient service in designated hospitals, the expenses below the Qifubiaozhun of the overall fund shall be paid; Expenses that exceed the minimum deductible and should be borne by individuals can be paid from personal accounts.
Extended data:
The basic medical insurance (overall fund) does not pay the cost of diagnosis and treatment projects include:
(1) service items
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for name calling operation, high quality and good price, and special care by oneself.
(2) Non-disease treatment projects
1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;
2. Various weight loss, weight gain and height increase projects;
3. Various health checks;
4, all kinds of prevention and health care projects;
5, tooth deformity, dental porcelain;
6, all kinds of medical consultation (excluding psychiatric consultation), medical appraisal.
(3) Diagnostic equipment and medical materials.
1, a project for examination and treatment with large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus;
2, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment;
3, all kinds of self-use health care, massage, rehabilitation and treatment equipment.
(4) Treatment items
1, the organ source or tissue source of various organ transplants or tissue transplants;
2. Transplantation of organs or tissues other than kidneys, heart valves, corneas, skin, blood vessels, bones and bone marrow;
3. Orthopedic surgery for myopia;
4, Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) Others
1, various infertility (pregnancy) and sexual dysfunction diagnosis and treatment projects;
2, all kinds of scientific research, clinical verification of diagnosis and treatment projects;
References:
Baidu encyclopedia-medical insurance reimbursement scope