At the same time, the five categories of items that are not included in the reimbursement of medical insurance are:
1, service items
1, registration fee, out-of-hospital consultation fee, medical record cost;
2, consultation fee, examination and treatment of expedited fee (except for the emergency room), surcharge on the name of the surgical surcharge, high-quality and high-priced fee, self-invited special nurses fee, and other special medical services.
Second, non-disease treatment program category
1, a variety of beauty (cosmetic life, medical cosmetology) fitness program as well as messy non-functional cosmetic surgery, orthopedic surgery, etc.;
2, a variety of weight loss, gain weight, increase the height of the project;
3, a variety of health checkups;
4, a variety of preventive, health care clinic programs;
5, dental orthopedics, dental orthodontics, dental surgery, dental surgery and other special needs services, such as nurse fees.
6, various medical consultation (excluding psychiatric consultation), medical appraisal.
Three, diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography device, electron beam CT, ophthalmic excimer laser therapy instrument and other large-scale medical equipment for the examination and treatment program;
2, glasses, dentures, prosthetic eyes, prosthetic limbs, hearing aids, and other rehabilitation appliances;
3, a variety of self-use health care, massage, rehabilitation and inspection treatment equipment.
Four, the treatment program category
1, all kinds of organ transplantation or tissue transplantation of organ source or tissue source;
2, in addition to kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation;
3, myopic orthopaedics;
4, qigong therapy, music therapy, health care of nutrition therapy, magnetic therapy and other complementary therapies therapy, magnetic therapy and other complementary therapeutic programs.
V. Other
1, various infertility (pregnancy), sexual dysfunction diagnosis and treatment programs;
2, a variety of scientific research, clinical verification of the diagnosis and treatment programs.
Legal basis:
Article 28 of the Social Insurance Law: Medical expenses that are in accordance with the basic medical insurance drug list, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 30: The following medical expenses shall not be included in the scope of payment of the basic medical insurance fund:
(1) those that should be paid from the Workers' Compensation Insurance Fund;
(2) those that should be borne by a third party;
(3) those that should be borne by the public ****health;
(4) those who seek medical treatment outside China.
Medical expenses shall be borne by a third party in accordance with the law, and if the third party fails to pay or if the third party cannot be identified, the basic medical insurance fund shall pay in advance. The basic medical insurance fund shall have the right to recover the costs from the third party after the first payment.