Medical assistive device insurance company reimbursement

Medical aids insurance company reimbursement is partially reimbursable, can be reimbursed for medical aids is generally based on the decision of different insurance companies, it is recommended that you should pay attention to the insurance company to communicate with the insurance company in advance, to see in the end what kind of medical aids can not be reimbursed.

I. The process of insurance reimbursement

1. Call your insurance company for advice immediately after reporting a medical claim. It is best to keep the filing time within three days, otherwise the claim will be affected by the statute of limitations.

2. The medical insurance contract will state the limit of medical treatment within the scope recognized by the insurance contract. You can only enjoy the medical insurance claim service if you go to the second class hospital or above.

3. Keep medical related invoices, bills, medical records and other information. All medical expenses should have corresponding invoices and itemized lists. Hospitalization summaries, medical records, original invoices, etc. should be kept in a safe place. In case of omission, a replacement certificate must be issued at the hospital and stamped with the hospital's official seal.

4. Fill out the Medical Insurance Claims Application Form and provide the required information, then you can wait for the insurance company to settle the claim.

Two, can be reimbursed for medical aids

Medicare insurance on the reimbursement of drugs and medical equipment has certain provisions, such as Category A and B drugs can be reimbursed (Category A drugs are clinically necessary, widely used, effective and inexpensive, and belong to the full reimbursement, while the Category B drugs are generally reimbursed 90%, and the individual to bear 10%), and some of the imported medicines and medical equipment are not reimbursed. . Disposable implantable artificial organs and medical materials. (1) Cost of IOL materials. (2) Cost of materials for heart valves. (3) Cost of materials for catheters and intraluminal stents used in the diagnosis and interventional treatment of coronary heart disease. (4) Cost of disposable medical materials for pacemakers and artificial joint replacements.

In summary, the medical aid insurance company reimbursement is part of the reimbursement can not be reimbursed, reimbursement of part of the clinical necessity, but for the imported and part of the drugs and equipment can not be reimbursed, the advice of the hospitalization and the doctor to ask well in advance.