What is not reimbursed by cooperative hospitals

The scope of cooperative medical care that cannot be reimbursed is as follows: those that should be borne by a third party; those that should be borne by public **** health; those that should be paid out of the Worker's Compensation Insurance Fund; and those that are sought outside the country. Medical expenses that meet the standards of the basic medical insurance drug catalog, diagnostic and treatment items, and medical service facilities, as well as those for emergencies and resuscitations, shall be paid out of the basic medical insurance fund in accordance with national regulations.

Expenses not reimbursed by medical insurance include:

1. Service items:

Registration fee, out-of-hospital consultation fee, medical record cost, etc.; consultation fee, expedited fee for examination and treatment, surcharge for named surgery, surcharge for named surgery, quality premium fee, self-initiated special nurses, and other special medical services;

2. Diagnostic and therapeutic equipments and medically useful materials:

The application of positronics is not covered by the basic medical insurance fund. p>

Application of positron emission tomography (PET), electron beam CT, ophthalmic excimer laser therapy and other large-scale medical equipment for examination and treatment programs. Eyeglasses, denture, eye prosthesis, prosthetic limbs, hearing aids and other rehabilitative appliances. All kinds of self-use health care, massage, examination and treatment equipment. Provincial price departments do not charge a separate charge for disposable medical materials;

3, therapeutic projects:

various types of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplants; myopic orthopaedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other auxiliary therapeutic programs.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses that are in line with the basic medical insurance drug list, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency treatment and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of insured persons 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.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.