Proportion of medical insurance reimbursement for ablation:
1. Cardiac ablation surgery belongs to the category of "heart disease" and can be reimbursed within the scope of basic medical insurance. The reimbursement rate is about 80%, and the individual pays 20%.
2. The cost of radiofrequency ablation surgery is generally between 10000 yuan and 30000 yuan, and the proportion of medical insurance reimbursement is about 60% to 70%.
The scope of medical insurance reimbursement for ablation:
1, medical insurance type: The medical insurance subsidy scope of radiofrequency ablation surgery mainly involves medical insurance, urban and rural residents' medical insurance and the new rural cooperative medical system. The reimbursement scope of medical insurance is very extensive. For eligible patients, medical insurance can reimburse all the expenses of radiofrequency ablation surgery. The proportion of medical insurance subsidies for urban and rural residents and new rural cooperative medical system patients varies from region to region, generally between 20% and 80%.
2. Diseases: For some specific diseases, such as patients with benign thyroid nodules treated by radiofrequency ablation, medical insurance may not be reimbursed; For other diseases, such as thyroid cancer patients undergoing radiofrequency ablation of thyroid nodules, medical insurance can be reimbursed.
3. Treatment: reimbursement for outpatient and inpatient treatment is also different. The cost of outpatient surgery in some hospitals can be directly reflected in outpatient treatment, and medical insurance can be reimbursed; For hospitalized patients, medical insurance can also be reimbursed, but preparations need to be made before the operation, and hospitalization observation is needed after the operation to make corresponding recovery.
To sum up, the proportion of medical insurance reimbursement for radiofrequency ablation is roughly between 60% and 70%, but the specific proportion needs to be determined according to local medical insurance policies and hospital regulations.
Legal basis:
People's Republic of China (PRC) social insurance law
second
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.