Non-disease treatment minimally invasive surgery, scientific research minimally invasive technology, heart, eye and organ minimally invasive surgery medical insurance will not be reimbursed.
The following items are not reimbursed by health insurance:
(I) Service item category.
(1) registration fee, out-of-hospital consultation fee, medical records cost;
(2) consultation fee, examination and treatment expediting fee, naming surgery surcharge, quality premium fee, self-employed special nurse and other special medical services.
(2) The category of non-disease treatment programs.
(1) a variety of beauty, fitness and non-functional cosmetic, orthopedic surgery;
(2) a variety of weight loss, weight gain, height projects;
(3) a variety of physical examination;
(4) a variety of preventive, health-care treatment programs;
(5) a variety of medical consultation, medical appraisal.
(3) diagnostic and treatment equipment and medical materials.
(1) the application of positron emission tomography device (PET), electron beam cT, ophthalmic excimer laser therapeutic instrument and other large-scale medical equipment for the examination and treatment program;
(2) glasses, denture, eye prosthesis, prosthetic, prosthetics, hearing aids and other rehabilitative appliances;
(3) all kinds of self-use of health care, massage, checking and treatment equipment;
(4) the provincial price department stipulates that the disposable medical use cannot be charged separately.
(4) treatment program category.
(1) all kinds of organ or tissue transplantation of organ source or tissue source;
(2) in addition to kidney, heart valves, cornea skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation;
(3) myopic orthopedic surgery;
(4) qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other complementary therapeutic projects.
(5) Others.
(1) a variety of infertility (pregnancy), sexual dysfunction diagnosis and treatment program;
(2) a variety of scientific research, clinical verification of the diagnosis and treatment program.
Medical insurance refers to the national legislation, in accordance with the principle of compulsory social insurance basic medical insurance premiums should be paid in full and on time by employers and individual employees. Do not pay in full and on time, does not count the individual account, the basic medical insurance fund will not pay their medical expenses.
Medical insurance reimbursement rate:
1, outpatient, emergency medical expenses: in the year of the active employees (January 1 ~ December 31) in line with the provisions of the basic medical insurance coverage of the accumulated medical expenses of more than 2000 yuan.
2. Settlement ratio: 50% reimbursement for the part of over 2,000 yuan for dispatched staff during the contract period, and 50% out-of-pocket payment by individuals; the maximum amount of outpatient and emergency reimbursement paid to dispatched staff is 20,000 yuan cumulatively in a year.
3. The insured personnel should keep the outpatient medical bills (including receipts and prescription bottoms for the parts below the large amount) of the outpatient treatment in the designated hospitals as the vouchers for the reimbursement of medical expenses.
4, three kinds of special disease outpatient medical treatment: participants suffering from malignant tumors radiation therapy and chemotherapy, kidney dialysis, kidney transplantation to take anti-rejection drugs need to be in outpatient medical treatment, by the participant's second and third-class designated hospitals for medical treatment issued a "diagnosis of the disease certificate" and fill out the "medical insurance special disease declaration and approval form", reported to the regional medical insurance center for approval and filing. The form will be submitted to the district medical insurance center for approval and filing. Outpatient medical treatment and medicine collection for these three special diseases are limited to the approved designated hospitals, and cannot be purchased at designated retail pharmacies. If the medical expenses incurred are within the scope of outpatient special diseases, they will be settled with reference to hospitalization.
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