Rizhao Warm Heart Insurance coverage includes:
1. Inpatient and outpatient medical expense coverage under medical insurance, 80% reimbursement after deducting 20,000 deductible, up to one million;
2. Outpatient hospitalization medical expense coverage under medical insurance, 60% reimbursement after deducting 20,000 deductible, up to one million;
3. Specific high-value drug expense coverage Specified Medication Expense Coverage*** Enjoys a deductible of 1.5 million, 60% reimbursement after deductible, up to a maximum of one million;
4.
Non-payable medical expenses:
1. Expenses not reimbursed under the medical insurance policy for personal reasons.
2. Expenses that should be paid from the Labor Injury Insurance Fund and Maternity Insurance.
3. Expenses that should be borne by a third party.
4. Expenses that should be borne by public **** health.
5. Expenses for medical treatment outside the country and in Hong Kong, Macao and Taiwan.
6. All kinds of infertility (pregnancy), sexual dysfunction diagnostic and treatment programs (such as male infertility, female infertility examination, treatment costs, violation of the birth policy of all medical costs), all kinds of teaching, scientific research and clinical verification of diagnostic and treatment program costs; sports and physical fitness, health care consumption, health check-ups, pre-marital check-ups, travel physical examination, occupational health check-ups, exit physical examination, and other non-disease treatment program type of costs. The cost.
7. Medicines purchased without a prescription from a designated specialist.
8. All kinds of medical appraisal costs (including but not limited to medical accident appraisal, psychiatric appraisal, pregnant women, fetal sex appraisal, injury detection, paternity testing, genetic appraisal and other costs).
9. Medical expenses incurred during the period of stopping the basic medical insurance for employees and residents in Rizhao City during the insurance period.
10. The overall non-reimbursable cases of the basic medical insurance for the current surgery or hospitalization, such as the expenses incurred for various cosmetic, plastic, non-functional orthopedic, weight loss, treatment of freckles, moles, skin care, dental implants, inlays, cleaning, prescription glasses, prosthetic eyes, prosthetic limbs, hearing aids, and so on.
The following medicines are not covered:
1. Healthcare medicines and vitamins and nutrients not covered by medical insurance: adenosine triphosphate and its compound preparations, coenzyme A and its compound preparations, compound coenzyme A, energy combinations, concentrated and diluted Levitra, hydrolyzed fetal cystic fibroblasts syrup, placenta globulin, placental proteins, and placenta albumin.
2. Prophylactic vaccines and contraceptive drugs.
3. Mainly for the treatment of hair loss, weight loss, beauty, smoking cessation, alcohol and other effects of drugs.
4. The cost of ointment prescriptions and the following medicines and traditional Chinese medicine tablets, which are mainly used for tonic and health care purposes as well as containing national precious and endangered wild plants and animals, are not included in the scope of coverage of the "Rizhao Warm Heart Insurance", specifically including: Colla Corii Asini, White Sugar Ginseng, Korean Ginseng, Pangasinan (Vinegar Pangasinan, Cannonball Pangasinan), Tortoiseshell Turtle, and Cordyceps Sinensis, Honey, dog treasure, turtle and deer gelatin, toad oil, sea dragon, seahorses, monkey jujube, propolis made from wine, antelope horn tip powder (antelope horn pound slice, antelope horn powder), antler velvet (antler velvet powder, antler slice), horse treasure, onyx, oxalis, coral, musk, Tianshan snow lotus, fresh dendrobium (dendrobium officinale), crocus sativus (saffron), American ginseng, blood exhaust, bird's nest, wild ginseng, migratory mountain ginseng, pearl, Zihechuan, all kinds of animal organs (except chicken lining gold) and fetus. (except for chicken internal gold) and tires, whips, tails, tendons and bones.
Note: The medicines listed above include raw medicines and concocted herbs and tablets.
4. Other non-payable expenses as stipulated in laws, regulations, policies, documents and insurance terms and conditions.