Extracorporeal ventilator emo medical insurance reimbursement

Whether the cost of ECMO will be reimbursed by the health insurance depends on the following:

1, ECMO itself is not covered by social health insurance, the normal period of time to the need for the patient to pay out of pocket, or reimbursement through commercial insurance, involving a very high level of use of consumables, is currently not in the scope of social health insurance.

2. If ECMO is used in the treatment of a new coronavirus infection, it is covered by the health insurance fund.

The following medical expenses will not be reimbursed:

1, unauthorized medical expenses incurred in non-designated medical institutions;

2, suicide, self-inflicted injuries (except mental illness);

3, fights, assaults, alcoholism, drug addiction, and other injuries or illnesses caused by crime or violation of public security management;

4, traffic accidents, accidental injuries, medical malpractice;

5, cosmetic, orthopedic, physiological defects, and so on.

6, belonging to the scope of payment of industrial injury insurance (including occupational disease) or maternity insurance;

7, the national and provincial medical insurance policy provides for other non-payment of fees.

Legal Basis:

Article 26 of the Social Insurance Law of the People's Republic of China

The basic medical insurance for employees, the new rural cooperative medical care and the basic medical insurance for urban residents shall be implemented in accordance with the national regulations.

Article 28

Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with the state regulations.

Article 29

The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and health shall establish a settlement system for medical expenses incurred in other places to facilitate the enjoyment of basic medical insurance by insured persons.

Article 30

The following medical expenses are not included in the basic medical insurance fund:

(a) should be paid from the workers' compensation insurance fund;

(b) should be borne by a third party;

(c) should be borne by the public **** health;

(d) medical treatment outside the country.