Circumstances that can not be reimbursed:
1, the cost of medical materials, such as: steel plates, proprietary plasters, a variety of cardiac stents, esophageal stents and so on.
2, Class B or Class C drugs, are not fully reimbursed, such as human albumin completely from the cost.
3, cannot be reimbursed for the cost of examination, such as MRI, CT, PET, etc.. Comprehensive medical insurance, hospitalization medical insurance, surgical medical insurance, a variety of allowances insurance and major disease insurance and other major disease insurance coverage ranges from 7 to 11 kinds of diseases, covering cardiovascular and cerebrovascular diseases, cancer, chronic renal failure, fulminant hepatitis, paralysis, and some other common major diseases. Allowance insurance is further divided into three types: general hospitalization medical allowance, cancer hospitalization medical allowance and hospitalization surgery medical allowance. Hospitalization medical insurance refers to the insurance that pays hospitalization medical insurance benefits as a percentage of the actual reasonable expenses incurred when hospitalization is necessary upon diagnosis by a hospital. Comprehensive medical insurance mostly covers categories of compensation such as fixed daily payment of hospitalization allowance and some special diseases or surgeries.
The national financing standards are not uniform, the reimbursement rates are not uniform, and the state allows for appropriate adjustments to be made within the scope of the policy in accordance with the actual situation of the regional economy.
However, there are four reimbursement modes:
One is outpatient coordinated reimbursement, spending the fees you paid when you enrolled in the program, reimbursing the use of the village health clinics and township health centers, which is limited to the outpatient account funds;
The second is outpatient reimbursement for chronic diseases, which is in line with the provisions of the management of chronic diseases, applying for the chronic disease card of the New Rural Cooperative Program (NRCP), and taking medicines or checking in the townships, counties, municipalities, and other public health care institutions.
Third is the major hospitalization reimbursement, hospitalization due to illness, can be reimbursed, but the reimbursement rate of reimbursement of the highest township hospitals, the lowest provincial level, general township hospitals reimbursement rate of 80-90%, the county hospitals 70-80%, municipal hospitals 55-65%, provincial hospitals reimbursement rate of 40-65%, and the provincial hospitals reimbursement rate of 40-65%. The treatment of cancer and so on.
Fifth, single-disease reimbursement, no matter how much money you spend, are reported then money, but the cost and reimbursement are based on professional arguments, the people will not lose, but if a small disease is a big doctor, it's hard to say.