Gastroenteroscopy can be reimbursed by health insurance under certain conditions. If it is an outpatient colonoscopy, it can only be paid for using the individual account of the health insurance, and cannot be reimbursed using the integrated account of the health insurance; however, if the colonoscopy is carried out when you are hospitalized due to a serious illness, it can be reimbursed using the integrated account of the health insurance. Gastroscopy is usually not reimbursable by medical insurance, but for patients with gastric cancer or malignant lymphoma of the stomach, if they are eligible for local chronic disease or major disease medical insurance coverage, they can be reimbursed, whether they are outpatient or hospitalized. To apply for reimbursement, you need to bring your medical record book, medical insurance card and ID card to the social insurance agency or designated medical institution.
Gastroenteroscopy reimbursement conditions:
1, the patient must have a valid medical insurance documents;
2, gastroenteroscopy should be prescribed by a doctor and meet the indications stipulated by the medical insurance;
3, the examination must be carried out in the designated medical institutions;
4, the patient needs to be reimbursed in accordance with the process of the medical policy;
5, patients need to follow the process of reimbursement;
5, gastroenteroscopy is not only a medical procedure, but also a medical procedure, and it can be used in a wide variety of medical institutions. p>
5. The cost of gastroenteroscopy must be within the scope of payment by the medical insurance, and the patient should pay for the excess.
In summary, gastroenteroscopy is within the scope of medical insurance reimbursement, colonoscopy can be reimbursed by medical insurance under certain conditions, while gastroscopy usually cannot be reimbursed by medical insurance, but for patients with gastric cancer or malignant lymphoma of the stomach, if they are eligible for the local chronic disease or major medical insurance coverage, they can be reimbursed whether they are outpatient or hospitalized. For reimbursement, you need to bring your medical record book, medical insurance card and ID card to apply to the social insurance agency or designated medical institution.
Legal basis:
The Social Insurance Law of the People's Republic of China
Article 28
Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.