Currently Nanchang three hospital hospitalization reimbursement rate of 60%, respectively, the reimbursement ceiling is 80,000 yuan. That is to say, if the operation is successful 100,000 yuan of surgical fees can be reported up to more than 50,000 yuan (after the starting line and out-of-pocket expenses).
If the surgery is unsuccessful, only a few expenses will be reimbursed, and the patient will be responsible for the costs incurred by the unsuccessful surgery, including catheters, balloons, and some other expenses used in the surgery. These auxiliary facilities and materials are disposable medical materials that are not charged separately and are not reimbursed by the health insurance; if the surgery is successful and a new stent is installed, then it is not considered disposable, and the other materials can be reimbursed along with it because they are not charged separately.
It is recommended that you find the local medical insurance department to consult, and check the relevant provisions of Jiangxi Province, some provinces of the price of the Department of the provisions of the disposable medical materials are not charged separately can not be reimbursed.
You look at the medical insurance regulations, can not be reimbursed range:
The first category is the class of services: registration fees, out-of-hospital consultation fees, medical records, etc.; clinic fees, examination and treatment of expedited fees, surcharges on the name of the surgical surcharge, surcharges on the name of the surgical surcharge, high quality and premium fee, self-invited special nurses and other special needs medical services.
The second category is the non-disease treatment program category: a variety of beauty, fitness programs and non-functional cosmetic surgery, orthopedic surgery, etc.; a variety of weight loss, weight gain, height projects; a variety of health body reimbursement; a variety of preventive, health care clinic programs; a variety of medical consultation, medical appraisal.
The third category is diagnostic and therapeutic equipment and medically useful materials: the application of positron emission tomography (PET), electron beam CT, ophthalmic excimer laser treatment device and other large-scale medical equipment for examination and treatment programs. Eyeglasses, denture, eye prosthesis, prosthetic limbs, hearing aids and other rehabilitative devices. All kinds of self-use health care, massage, examination and treatment equipment. Provincial price departments do not charge separately for disposable medical materials.
The fourth category is the category of therapeutic projects: all kinds of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation; myopic orthopedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other complementary therapeutic projects.
The fifth category is other categories: various infertility (pregnancy), sexual dysfunction diagnosis and treatment programs; a variety of scientific research, clinical verification of the diagnosis and treatment programs.
In addition, the basic medical insurance does not pay the cost of: on (transfer) transportation costs, emergency vehicle costs; air conditioning costs, telephone costs, telephone costs, baby warming box costs, food warming box costs, electric stoves, refrigerators, and compensation for damage to public property insurance single number of nurses, nursing costs, cleaning costs, outpatient decoctions; meals; recreational activities and other special needs of the cost of living services. Patients should pay for all of the above items when they seek medical treatment.