In Zhejiang Province, for example, some of the medical rehabilitation programs are covered by basic medical insurance. In other words, not all of them are included, only part of them are included in the medical reimbursement scope.
In accordance with the relevant provisions of the Notice on the inclusion of some medical rehabilitation projects in the scope of basic medical insurance, Zhejiang Province, hemiplegic limb comprehensive training and other 25 medical rehabilitation projects into the scope of basic medical insurance, since January 1, 2011, respectively, included in the urban workers' basic medical insurance, urban residents' basic medical insurance, the new rural cooperative medical care medical service project payment scope. The company will also be able to provide the necessary services to the public in the future.
Not only are some of the rehabilitation programs included in the scope of medical insurance, but there is also a limited scope of payment. Taking hemiplegic comprehensive limb training as an example, although it is included in the scope of medical insurance, but the hemiplegic comprehensive limb training is mainly for a disease process to pay for no more than 3 months. Only 1 of these is paid when used in conjunction with exercise therapy.
Some are also limited to children, such as integrated cerebral palsy limb training, which is limited to children. In particular, no more than 6 months per year are paid before age 3; after age 3, no more than 3 months per year are paid. The total number of years of payment does not exceed 5 years, and only 1 of these is paid when used in conjunction with exercise therapy. In other words, this type of illness is only reimbursable for children up to the age of 3 years.
Expanded information:
Taking Zhejiang Province as an example, Zhejiang has included 13 medical rehabilitation programs, such as the unarmed balance function examination, in the scope of payment of basic medical insurance, while adjusting the scope of payment of basic medical insurance payment of speech ability assessment (general aphasia examination) and other nine medical rehabilitation programs limited payment.
The notice also stipulates that the payment for rehabilitation treatment for a disease process shall not exceed 90 days in principle (rehabilitation treatment for mental disorders shall not exceed 90 days per year, and cerebral palsy shall be implemented in accordance with the limited payment regulations of the program). For patients who have exceeded the specified payment period, the medical institutions with qualifications in rehabilitation medicine treatment will assess and, after review and approval by the health insurance administration organization, the payment period can be extended appropriately.
The extended payment period shall not exceed 3 months in principle (cerebral palsy shall be implemented according to the prescribed payment period).
Zhejiang government service network - on the part of the medical rehabilitation program into the scope of basic medical insurance