Basic medical insurance can not be fully reimbursed for the diagnosis and treatment items
1, diagnostic and treatment equipment and medical materials are:
(1) x-ray computed tomography (ct), stereotactic radiography, cardiac and angiography x-ray machine (including digital subtraction equipment), Magnetic *** vibration imaging device (mri), single photon emission computer scanning device (spect), color Doppler, linear gas pedal and other large-scale medical equipment for examination and treatment items. The deductible is 30% for examination items and 20% for treatment items.
(2) Extracorporeal shock wave lithotripsy, hyperbaric oxygen therapy, radiofrequency therapy, etc., will be covered at 20%.
(3) Individuals will pay 50% for the installation of various artificial organs and materials placed inside the body (e.g., pacemakers, artificial joints, artificial crystals, artificial larynx, artificial femoral head, artificial heart valves, vascular stents, etc.).
(4) 30% of the disposable medical materials that can be charged separately as stipulated by the price department of Sheng City.
2. Treatment Programs
(1) Hemodialysis and peritoneal dialysis: 10%.
(2) Kidney, heart valve, cornea, skin, blood vessel, bone and bone marrow transplantation 30% out-of-pocket.
(3) Cardiac bypass, cardiac catheter balloon dilatation, cardiac stenting, drainage, cardiac laser perforation, coronary angiography, cardiac electrophysiology radiofrequency ablation, anti-tumor cellular immunotherapy and fast neutron therapy, and a variety of interventional procedures pay 20% out-of-pocket.
The diagnostic and therapeutic items belonging to the above basic medical insurance fund to pay part of the cost, must be by the price department has set the fee standard diagnostic and therapeutic items, in the diagnosis and treatment or for the settlement of the medical fee for the discharge, first by the insured person in accordance with the prescribed proportion of cash out-of-pocket, and then the other part of the basic medical insurance regulations by the coordinated fund to pay for the account, the following cases occurring in the medical expenses are not included in the basic medical insurance reimbursement Scope:
1, do not go to the designated institutions for consultation, enough medicine, not in accordance with the catalog of diseases and the prescribed procedures for admission and transfer;
2, belonging to the responsibility of other responsible persons should be borne but the responsibility. Such as medical malpractice, traffic accidents.
3, industrial accidents, female workers give birth;
4, the person's own offense, sobriety, self-injury, self-inflicted injuries caused by various reasons.
5, lending the card or card to another person or using another person's card or card to visit the clinic under false name.
6, private alteration of prescriptions, or false or overbilling of medical bills, fraudulent collection of funds;
7, for their own reasons, do not strictly abide by the management system of medical insurance;
8, other responsibilities that do not belong to the medical insurance should be borne by but.
In accordance with the provisions of the basic medical insurance does not pay the cost of diagnosis and treatment items *** five categories.