1, the part where the personal account balance of the first-class insured in Shenzhen's basic medical insurance exceeds 5% of the average annual salary of employees in this city in the previous year.
2, more than part of the parents, spouses and children have participated in medical insurance in our city, can pay part of the designated medical expenses. This method is called "family channel".
First, the basic insurance does not pay the cost of the scope of medical treatment projects.
(1) service items
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for roll call operation, high quality and good price, and special care by oneself.
(2) Non-disease treatment projects
1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;
2. Various weight loss, weight gain and height increase projects;
3. Various health checks;
4, all kinds of prevention and health care projects;
5, tooth deformity, dental porcelain;
6, all kinds of medical consultation (excluding psychiatric consultation), medical appraisal.
(3) Diagnostic equipment and medical materials.
1, a project for examination and treatment with large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus;
2, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment;
3, all kinds of self-use health care, massage, rehabilitation and treatment equipment.
(4) Treatment items
1, the organ source or tissue source of various organ transplants or tissue transplants;
2. Transplantation of organs or tissues other than kidneys, heart valves, corneas, 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;
The scope of the basic medical insurance to pay part of the cost of diagnosis and treatment projects.
(a) diagnosis and treatment equipment and medical materials
1, using X-ray computed tomography (CT), stereotactic radiotherapy device (γ knife, χ knife), cardiac and angiographic X-ray machine (including digital subtraction equipment), magnetic resonance imaging device (MEI), single photon emission computerized scanning device (SPECT), color Doppler instrument, medical linear accelerator and other large medical equipment.
2. Extracorporeal shock wave lithotripsy and hyperbaric oxygen therapy;
3. Pacemakers, artificial joints, intraocular lenses, vascular stents, etc. replace artificial organs in vivo and place materials in vivo;
4, the provisions of the provincial price department can be charged separately for disposable medical materials.
(2) Treatment items
1, hemodialysis, peritoneal dialysis;
2. Transplantation of kidney, heart valve, cornea, skin, blood vessels, bone and bone marrow;
3. Cardiac laser drilling, anti-tumor cellular immunotherapy and fast neutron therapy projects.
Legal basis:
Measures of Shenzhen Municipality on Social Medical Insurance
Forty-eighth basic medical insurance for a class of insured personal accounts accumulated more than 5% of the average wage of employees in the city last year, the excess can be used to pay the following expenses:
(1) The expenses for purchasing non-prescription drugs within the scope of the basic medical insurance and local supplementary medical insurance drugs list in designated retail pharmacies;
(two) the basic medical expenses and local supplementary medical expenses paid by myself, my spouse and the immediate family members who have participated in the basic medical insurance in this Municipality when they visit the designated medical institutions;
(three) the cost of health examination and vaccination for himself and his spouse and his immediate family members who have participated in the basic medical insurance in this Municipality;
(four) other medical expenses stipulated by the state, Guangdong Province and this Municipality.