Medical insurance reimbursement scope refers to the basic medical insurance to protect the basic medical needs of the participants, standardize the basic medical insurance medication, diagnosis and treatment and other aspects of the management of the basic medical insurance, the basic medical insurance provides for the reimbursement of drug directory, diagnostic and treatment items and medical service facilities (commonly known as the "three directories"). (commonly known as the "three catalogs"). The medical insurance fund pays for the medical expenses incurred by the insured in the designated hospitals that are in line with the three catalogs in accordance with the regulations.
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I. Medical insurance reimbursementThe scope of urban medical insurance reimbursement refers to all employers in cities and towns, as shown below:
1. Including enterprises (state-owned, collective, foreign-invested, private enterprises, etc.);
2. Institutions, institutions, social organizations, private non-enterprise units and their employees, all of them are required to participate in basic
3. Some cities and towns require that township and village enterprises and their employees, as well as owners of self-employed economic organizations and their employees, be gradually included in the scope of basic medical insurance (the last of which varies from place to place depending on the policies of each place), so that they can enjoy medical reimbursement. Urban medical reimbursement mainly refers to is in the hospital to see a doctor, medicine, hospitalization, surgery, etc., can be through the medical insurance card in accordance with the relevant provisions of the medical expenses reimbursement, urban medical insurance is more specialized, the project size and coverage is larger, but its in major diseases or accidents in the payout is limited, the author suggests that the participants can be purchased separately commercial major medical illnesses supplemental insurance and social security for a combination of ways to reduce their financial losses.
Basic insurance does not pay the cost of the scope of treatment items
1, registration fees, out-of-hospital consultation fees, medical records and other fees;
2, consultation fees, examination and treatment of expedited fees (except for emergencies), surcharge surcharge surgery by name, high quality and premium fees, self-invited special nurses and other special medical services.
(2) non-disease treatment program category
1, a variety of cosmetic (cosmetic life, medical cosmetology) fitness program and messy non-functional cosmetic surgery, orthopedic surgery, etc.;
2, a variety of weight loss, gain weight, increase in height project;
3, a variety of health checkups;
4, a variety of preventive, health care diagnostic and therapeutic programs
() (C) diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography device, electron beam CT, ophthalmic excimer laser treatment instrument and other large medical equipment for examination and treatment programs;
2, eyeglasses, dental prostheses, eye prostheses, prosthetic limbs, hearing aids, and other rehabilitation appliances;
3, a variety of self-use health care, massage, examination and rehabilitation and treatment equipment.