The expenses for EEG, X-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, CT and nuclear magnetic resonance in the auxiliary examination center are limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.
The general process of reimbursement is: holding the medical insurance manual and IC card->; Hospital medical insurance office registration->; Verification card-payment of hospitalization deposit->; Hospitalization-For self-funded projects, patients must agree and sign-> Minimum payment standard for cash or IC card settlement and self-payment part of self-payment ratio->; Within the scope of overall planning, the hospital will give priority to support-> Settle down and leave the hospital
Extended data:
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.
Proportion of medical insurance reimbursement:
1, outpatient and emergency medical expenses: the medical expenses that meet the requirements of basic medical insurance in the year (11October1February 31February) exceeded 2,000 yuan.
2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.
3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.
4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies.
Baidu encyclopedia-medical insurance reimbursement scope