ICU can be reimbursed for cardiac monitoring fees, ventilator fees, injection fees, diagnostic fees and other items in the medical insurance reimbursement catalog. Imported drugs, if used, are not reimbursed if they are not in the reimbursement catalog of the medical insurance.
Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by the risk of illness. Through the employer and individual contributions, the establishment of a medical insurance fund, the insured person sick visit medical expenses incurred by the medical insurance organization to give them a certain amount of financial compensation. The establishment and implementation of the basic medical insurance system gathered the economic strength of the unit and members of the community, coupled with the government's financial support, can make the sick members of the community from the community to obtain the necessary material help, reduce the burden of medical expenses, to prevent the sick members of the community due to disease to poverty.
Medical insurance, like other types of insurance, is a contractual way of collecting medical insurance premiums in advance from people threatened by illness and establishing a medical insurance fund. When the insured person falls ill and goes to a medical institution and incurs medical expenses, the medical insurance organization will give some financial compensation. Therefore, medical insurance also has two major functions of insurance, risk transfer and compensation transfer. That is to say, the economic loss caused by the risk of disease on an individual is spread to all members who are threatened by the same risk, and the concentrated health insurance fund is used to compensate for the economic loss caused by the disease.
Commercial medical insurance can be divided into reimbursement medical insurance and compensation medical insurance:
1. Reimbursement medical insurance refers to the patient's medical expenses in the hospital are reimbursed by the insurance company, which is generally divided into outpatient medical insurance and inpatient medical insurance;
2. Compensation medical insurance refers to the patient is diagnosed by the hospital as suffering from a certain disease listed in the contract. It is generally divided into single disease insurance and major disease insurance.
Legal basis
The Social Insurance Law of the People's Republic of China
Article 29: The portion of the medical expenses of the insured that shall be paid by the basic medical insurance fund shall be settled directly by the social insurance agency with the medical institutions and the drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.