Is there any medical insurance reimbursement for radiotherapy expenses now?
First, are radiotherapy expenses reimbursed by medical insurance now? Radiotherapy can be reimbursed by medical insurance. In general outpatient service, the overall fund is ignored. It mainly deals with reimbursement of special outpatient and hospitalization expenses. But the cost of radiotherapy depends on your medical insurance type, which is a question of how much to report. Reimbursement for special outpatient service refers to the reimbursement of treatment expenses arising from cancer radiotherapy and chemotherapy and uremia dialysis, excluding operation expenses. The reimbursement of hospitalization expenses refers to the reimbursement of general hospitalization expenses and the reimbursement of hospitalization expenses seven days before emergency. The general outpatient service, special outpatient service and hospitalization of the overall fund are not reimbursed, and the provisions are: 85%-97% reimbursement, deductible line 1.300 yuan. The upper limit of annual cumulative expenses is 70,000 yuan. Its reimbursement ratio is inversely proportional to the level of the hospital and directly proportional to the number of drugs prescribed. The higher the cost, the higher the reimbursement ratio. Second, what should I pay attention to during radiotherapy? In the process of radiotherapy, some patients are accompanied by changes in sense of smell and taste, such as bitter taste, no sweetness or sugar, and unbearable cooking taste. Therefore, in food preparation, we should pay attention to color, aroma and taste, eat a little more meals, properly control the pain before meals, and take a walk before meals. At the same time, it is necessary to ban alcohol, avoid irritating foods such as spicy frying and hard food, encourage patients to drink more soup, and accelerate the excretion of toxins in the body. Three. Settlement Procedures (I) Settlement Procedures for Hospitalization and Outpatient Treatment of Special Diseases Designated medical institutions shall report the expense list, hospitalization list and related materials of patients discharged from the hospital last month to the medical insurance agency before 10, and the medical insurance agency will review them as the basis for monthly pre-allocation and year-end final accounts. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month. Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately. (II) Emergency Settlement Procedure The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall go through the reimbursement procedures according to the provisions with the hospital emergency medical records, inspection, laboratory reports, invoices and detailed list of medical expenses. (3) Settlement procedures for people resettled in different places 1. Resettlement personnel in different places are designated as designated medical institutions by their units with their residence 1-2, and reported to the medical insurance agency for the record. 2. The medical expenses incurred by the off-site staff in their place of residence in the outpatient department of designated medical institutions shall be paid in advance by themselves or their units. After the end of the treatment, the unit shall settle the account with the social medical insurance agency on the specified date with the medical certificate and medical record of the insured, effective bills, compound prescriptions, hospitalization expenses list, etc. (4) Referral and settlement of referral 1. If the insured person is transferred to other medical institutions for diagnosis and treatment due to the conditions of designated medical institutions or specialized diseases, it is necessary to fill in the referral and referral approval form. The reason for referral and transfer is put forward by the attending physician, the director of the department puts forward the opinion of referral and transfer, the medical institution medical insurance office reviews it, the dean in charge signs it, and it can be transferred only after being reported to the municipal medical insurance center for examination and approval. 2. In principle, referrals should be made outside the city, inside the province and outside the province. The city's referral regulations are carried out between designated medical institutions. The referral outside the city is proposed by the designated medical institutions above Grade III in this Municipality. 3. The medical expenses incurred after the insured person is referred to another hospital shall be paid by the individual or unit in cash. After the medical treatment, the insured person or his agent will submit the referral approval form, medical record certificate, prescription and valid documents to the medical insurance agency for reimbursement of hospitalization expenses that fall within the scope of the overall fund payment. To sum up, whether medical insurance can be guaranteed or not cannot be generalized, because the scope of medical insurance reimbursement is limited, radiotherapy also depends on what kind of radiotherapy and medical insurance policy at that time, what kind of medical insurance you buy, and some are only the medical expenses insured in that area, and so on. It's not the cost of surgery, so the specific insurance depends on the specific situation.