CT examination and nuclear magnetic **** vibration examination are within the scope of reimbursement of basic medical insurance. CT examination costs incurred during hospitalization can be reimbursed at a certain rate; outpatient CT examination costs are reimbursed according to the specific regulations of the local social security bureau. Nuclear magnetic **** vibration examination costs can also be reimbursed through the basic health insurance, the reimbursement rate is usually 70%, but the exact percentage also needs to be determined according to the type of health insurance of the individual. The costs reimbursed by the health insurance are calculated by multiplying the balance of the reimbursement rate after deducting the hospital's threshold, out-of-pocket drug and out-of-pocket examination costs. These costs are settled directly between the social insurance administration organization and the medical institution or drug business unit.
Conditions for reimbursement of medical insurance:
1. Identity of the insured: the insured must be enrolled in medical insurance and within the validity period;
2. Scope of reimbursement: according to the provisions of the local medical insurance policy, it usually includes the cost of drugs, diagnostic and therapeutic items, and examination fees;
3. Procedure of medical treatment: the insured need to follow the stipulated procedure of medical treatment, such as first going to community hospitals, and then going to the hospitals of the community.
4, designated medical institutions: must be in the medical insurance designated medical institutions for examination and treatment, non-designated institutions of the expenses incurred are generally not reimbursed;
5, reimbursement rate: according to different types of health insurance and policy, the reimbursement rate will be different;
6, out-of-pocket expenses: some of the high-end medical services or ultra-standard treatment costs may fall under the category of out-of-pocket expenses and are not covered by reimbursement.
In summary, CT and NMR*** vibration examinations can be reimbursed through basic medical insurance, with the reimbursement rate determined according to the type of individual medical insurance, and the costs settled directly between the social insurance agency and the medical institution or drug business unit.
Legal basis:
The Social Insurance Law of the People's Republic of China
Article 28
Medical expenses in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as emergency and salvage medical expenses shall be paid from the basic medical insurance fund in accordance with state regulations.