The following items are not included in the scope of medical insurance reimbursement:
(1) service items.
(1) Registration fee, out-of-hospital consultation fee, medical record fee, etc.
(2) Special medical services, such as visiting fees, expedited fees for examination and treatment, additional fees for roll-call surgery, high-quality and low-price fees, and self-invited intensive care.
(2) Non-disease treatment projects.
(1) all kinds of beauty and bodybuilding, as well as non-functional plastic surgery and orthopedic surgery;
(2) various weight loss, weight gain and height increase projects;
(3) various health checks;
(4) all kinds of preventive health care and diagnosis projects;
(5) all kinds of medical consultation and medical appraisal.
(3) Diagnostic equipment and medical materials.
(1) Examination and treatment items of large medical equipment such as positron emission tomography (PET), electron beam cT and ophthalmic excimer laser therapeutic instrument;
(2) glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation devices;
(3) all kinds of self-use health care, massage, examination and treatment equipment;
(4) The provincial price department stipulates that one-time medical treatment cannot be charged separately.
(4) Treatment items.
(1) The organ source or tissue source of various organ or tissue transplants;
(2) Transplantation of organs or tissues other than kidneys, heart valves, corneal skin, blood vessels, bones and bone marrow;
(3) Orthopedic surgery for myopia;
(4) Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) others.
(1) various infertility (pregnancy) and sexual dysfunction diagnosis and treatment projects;
(2) all kinds of scientific research and clinical verification of diagnosis and treatment projects.
Medical insurance refers to the basic medical insurance premium paid in full and on time by employers and employees according to the principle of compulsory social insurance through national legislation. If it is not paid in full and on time, the basic medical insurance fund will not pay its medical expenses regardless of individual accounts.
Medical insurance is insurance to compensate medical expenses caused by diseases. Social insurance in which employees are provided with necessary medical services or material assistance by society or enterprises due to illness, injury or childbirth. For example, free medical care and labor insurance medical care in China.
Legal basis:
Regulations on Basic Medical Insurance for Urban Workers in People's Republic of China (PRC) Article 41 The administrative department of labor and social security of the province shall, in accordance with the relevant provisions of the state, determine the list of drugs for basic medical insurance in conjunction with the administrative departments of planning, economy, trade, finance, health and drug supervision and administration. The provincial labor and social security administrative department shall, in accordance with the relevant provisions of the state, jointly with the planning, finance, health administration and drug supervision and management departments, determine the basic medical insurance diagnosis and treatment project directory, the scope of medical service facilities and payment standards. The use of drugs, medical treatment projects and medical service facilities that are not included in the basic medical insurance coverage will not be paid by the overall fund.