"Three catalogs" of health insurance can be reimbursed which, mainly depends on the health insurance catalog. The medical insurance catalog includes medical insurance drug catalog, diagnosis and treatment items catalog and medical service facilities scope catalog, that is, "three directories". Only medical expenses within the "three catalogs" can be reimbursed.3. Starting line, ceiling lineThe starting line refers to the starting standard of the medical insurance fund, and the insured person who actually incurs the medical expenses within the "three catalogs" in the designated medical institution will have to bear the starting line first. The part above the threshold will be reimbursed by the medical insurance fund in accordance with the regulations and proportions. 。。。。
The medical insurance fund will not pay for medical expenses that are not included in the "three catalogs".
Medicare reimbursement detailed list is as follows:1, general medical insurance. Mainly includes outpatient costs, medicine costs, examination costs, etc.2. Hospitalization insurance. Mainly daily hospitalization fees, the cost of using hospital equipment, surgical costs, medical expenses, etc. 3, surgical insurance. Provides all the expenses incurred due to the patient's need for necessary surgery.4. Comprehensive medical insurance. Its cost scope includes all costs of medical treatment and hospitalization and surgery, etc. 5. Special disease insurance. Certain special diseases often bring the patient catastrophic cost payment, which is difficult for the average resident family to bear. Examples include cancer and heart disease. Provide coverage for policyholders of major diseases, can be a single, such as malignant tumors, or even malignant tumors in a certain number of cancers.
I hope the above can help you, if there are still questions please consult a professional lawyer.
Legal basis:
Article 8 of the Rules for the Implementation of the Social Insurance Law of the People's Republic of China*** and the State of China
Participants in the agreement of the medical costs incurred in the medical institutions, in line with the basic medical insurance drug directory, diagnostic and therapeutic items, medical services and facilities standards, in accordance with national regulations from the basic medical insurance fund.