Checkups are generally not covered by health insurance, but many individual tests can be reimbursed using health insurance. The following items are not covered by medical insurance:
Services:
Registration fee, out-of-hospital consultation fee, medical record cost, etc.;
Outpatient consultation fee, expedited fee for examination and treatment, surcharge for named surgery, quality and premium fee, and self-initiated special nurses and other special medical services.
Non-disease treatment programs:
All kinds of cosmetic and body-building programs and non-functional cosmetic and orthopedic surgeries;
All kinds of weight-loss, weight-gain and height-enhancement programs;
All kinds of health checkups;
All kinds of preventive and health care programs;
All kinds of medical consulting and medical appraisals.
Diagnostic and therapeutic equipment and medical materials:
Application of positron emission tomography (PET), electron beam cT, ophthalmology excimer laser treatment instrument and other large-scale medical equipment for the examination, treatment programs;
Glasses, dentures, prosthetic eyes, prosthetic limbs, hearing aids and other rehabilitation devices;
All kinds of health care for their own use, massage, examination and treatment equipment;
All kinds of health care, massage, examination and treatment equipment;
All kinds of medical consultations, medical identification.
Disposable medical supplies that cannot be charged separately as stipulated by the price department of each province;
Treatment item category:
Organ source or tissue source of all kinds of organ or tissue transplants;
Other organ or tissue transplants except for kidney, heart valves, cornea skin, blood vessels, bone and bone marrow transplants;
Myopia orthopedic surgery;
Assistive therapeutic programs such as qigong therapy, music therapy, nutrient therapy for health care, magnetic therapy, etc.
Others:
All kinds of infertility and sexual dysfunction treatment programs;
All kinds of scientific research and clinical verification treatment programs.
Expanded Information:
Medicare refers to social health insurance. Social medical insurance is a social insurance system established by the state and society in accordance with certain laws and regulations in order to provide workers covered by the insurance with protection for their basic medical needs in the event of illness.
The basic medical insurance fund consists of a centralized fund and individual accounts. The basic medical insurance premiums paid by individual workers are all credited to individual accounts; the basic medical insurance premiums paid by employers are divided into two parts, one of which is allocated to individual accounts and the other is used to build up the coordinated fund.
On January 12, 2016, the State Council issued the Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents, which called for promoting the integration of the urban residents' medical insurance and the New Rural Cooperative Medical Insurance systems, and gradually setting up a unified medical insurance system for urban and rural residents nationwide.
On Dec. 20, 2016, the Ministry of Human Resources and Social Security held a video conference on the work of nationwide networking of basic medical insurance and direct settlement for medical treatment in other places, and signed a work responsibility letter with 22 provinces, including Beijing, that had applied for the first batch of activation of nationwide networking of basic medical insurance and direct settlement of medical treatment in different places across provinces, marking the official shift of the work of direct settlement of medical treatment in different places across provinces to the implementation stage.
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