Legal analysis: whether the surgery fee can be reimbursed is treated in different situations, mainly divided into three categories.
1, the basic medical insurance does not pay the cost of the scope of treatment items: all kinds of organ or tissue transplantation of organ source or tissue; all kinds of cosmetic, bodybuilding projects and non-functional cosmetic, orthopedic surgery; myopic orthopedic surgery;
2, the basic medical insurance to pay part of the cost of the scope of treatment items: pacemakers, artificial joints, artificial crystals, vascular stents and other in vivo replacement of artificial organs, internal replacement materials; kidney, heart valves, corneas, vascular stents and so on. Artificial organs and materials placed in the body; kidney, heart valve, cornea, skin, blood vessel, bone and bone marrow transplantation; cardiac laser perforation, anti-tumor cellular immunotherapy and fast neutron therapy program; hemodialysis, peritoneal dialysis;
3. Normal coverage of the basic medical insurance: In addition to the scope of the diagnostic and therapeutic items that do not pay for the cost and the scope of the diagnostic and therapeutic items that pay for a portion of the cost, which belongs to the urban and rural residents' medical insurance fund payment scope;
2. urban and rural residents medical insurance fund to pay the scope of the medical insurance designated medical institutions to keep accounts, urban and rural residents medical insurance fund in accordance with the provisions of the payment.
Legal basis: The Social Insurance Law of the People's Republic of China
Article 2 The State establishes a social insurance system for basic old-age pension insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance and other social insurance, and guarantees the right of citizens to obtain material assistance from the State and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment or maternity.
Article 26 The standards of treatment for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be carried out in accordance with the provisions of the State.
Article 28 Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency and rescue shall be paid from the basic medical insurance fund in accordance with the state regulations.