1. Generally, the general population pays for gastrointestinal endoscopy at their own expense.
2. If it is reasonable and necessary to be hospitalized for gastrointestinal endoscopy, then medical insurance can generally be reimbursed. Of course, the premise is that the related medical expenses can only be reimbursed after exceeding the deductible of medical insurance, and the specific reimbursable expenses should also be subject to the insurance contract.
3. Anesthetic drugs for painless gastroscopy need to be paid at their own expense.
4, there are differences in different regions, some places can be reimbursed, specifically to consult the local hospital.
After the medical insurance reimbursement, the insurance company can also report it. Details are as follows:
1. If the insured has bought both medical insurance and commercial insurance, they can be reimbursed as long as they meet the requirements of insurance reimbursement. Generally, it is within the scope of medical insurance first, and the rest is reimbursed by commercial insurance. Moreover, for the reimbursement ratio of the two, if it is reimbursed through medical insurance, the rest of commercial insurance can generally be reimbursed 80%, and if it is not reimbursed through medical insurance, it can only be reimbursed 60%;
2. If there is no medical insurance reimbursement, the insurance company can only reimburse 60%~80% directly.
3. Self-funded drug reimbursement cannot be reimbursed through the national medical insurance catalogue, and it needs commercial medical insurance reimbursement.
As can be seen from the above, the outpatient gastrointestinal endoscopy of the general population cannot be reimbursed, but if there are indications for gastrointestinal endoscopy during hospitalization, it can be reimbursed by medical insurance.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.