ECMO scientific name extracorporeal membrane pulmonary oxygenation, mainly used to provide continuous extracorporeal respiration and circulation to patients with severe cardiorespiratory failure, in order to maintain the patient's life. The start-up fee is the most expensive, at 50,000-60,000 yuan, and other costs to keep the machine running and medical expenses, at about 1,000-2,000 per day, according to the patient's use of artificial lungs for a period of about 20 days, the cost of about 20,000 to 40,000 yuan, so the use of artificial lungs for a period of time, about 100,000 yuan is needed, this cost is still relatively expensive, and will cause financial pressure on many families.
What is the rate of reimbursement for ecomo medical insurance?
ECMO itself is not covered by social health insurance and requires patients to pay out-of-pocket or be reimbursed through commercial insurance during normal times. However, if ECMO is used in the treatment of a new crown, it will be paid for by the health insurance fund.
Taking Million Healthcare as an example, Million Healthcare's reimbursement rate ranges from 50% to 100%, depending on the insured's insurance contract as well as the insured's situation. Generally speaking, the higher the premium, the higher the level of coverage, and the reimbursement rate will increase accordingly.
Meanwhile, the reimbursement rate may be affected by the adjustments and policy changes of the insurance company, so the insured needs to pay attention to the notices of the insurance company and the policy changes in order to keep abreast of his/her insurance rights and interests.
The use of ECMO in the treatment of new crowns is paid for by the health insurance fund. According to the law, in line with the basic medical insurance drug catalog, diagnostic and treatment items, medical service facilities standards, as well as emergency, rescue medical expenses, in accordance with national regulations from the basic medical insurance fund. The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
Overall, ECMO is not reimbursed in the social security insurance, under normal circumstances, it is necessary for the patient to pay out of pocket or commercial insurance reimbursement, but because of the treatment of new coronary artery disease requires ECMO, it is reimbursed by the medical insurance fund, the special circumstances of the adoption of special policies.