In accordance with the "on the part of the medical rehabilitation project into the scope of basic medical insurance notice" relevant provisions of Zhejiang Province, hemiplegic limb comprehensive training and other 25 medical rehabilitation projects into the scope of basic medical insurance, since January 1, 2011 were included in the basic medical insurance for urban workers, urban residents of the basic medical insurance, the new rural cooperative medical medical care services to pay for the scope of medical services. The government will pay for it according to the regulations.
Not only are some of the rehabilitation programs included in the scope of medical insurance, but there is also a limited scope of payment. Taking hemiplegic comprehensive limb training as an example, although it is included in the scope of medical insurance, but the hemiplegic comprehensive limb training is mainly for a disease process to pay for no more than 3 months. Only 1 of these is paid when used in conjunction with exercise therapy.
Some are also limited to children, such as integrated cerebral palsy limb training, which is limited to children. In particular, no more than 6 months per year are paid before age 3; after age 3, no more than 3 months per year are paid. The total number of years paid does not exceed 5 years, and only 1 of these is paid when used in conjunction with exercise therapy. In other words, this type of illness is only reimbursable for children up to the age of 3.
Rural Cooperative Medical Insurance
(1) Reimbursement Scope:
1. Pharmaceutical Fees: Auxiliary Examinations: Limit of 200 RMB for each examination such as EKG, X-ray Fluoroscopy, Film, Laboratory Tests, Physiotherapy, Acupuncture and Moxibustion, CT, Nuclear Magnetic *** vibration, etc; Surgical Fees (with reference to the national standard, reimbursement for more than 1000 RMB is made according to the amount of 1000 RMB).
2. When the elderly over 60 years old are hospitalized in Xingta Township Health Center, the treatment fee and nursing fee are compensated 10 yuan per day with a limit of 200 yuan.
(2) Excluded from the scope of reimbursement:
1, self-medical treatment (without designated hospitals for medical treatment or without a referral order), self-purchased medicines, medicines not reimbursable under the provisions of public medical treatment and medical expenses not in line with family planning;
2, outpatient treatment, consultation fees, hospitalization, meals, accompanying guests, nutritional expenses, blood transfusion (except those with family blood storage, which is reimbursed in accordance with the relevant regulations for reimbursement), air-conditioning and heating expenses, ambulance fees, special nursing fees and other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents, and medical malpractice;
4. Orthopedics, plastic surgery, dental implants, prosthetics, organ transplants, named surgery fees, consultation fees and other expenses;
5. Reimbursement of expenses within the scope of reimbursement, but not outside of the limit.