Reimbursement scope of medical insurance card

Acute severe trauma, brain injury, fracture, dislocation, laceration, burn, sudden acute abdominal pain, sudden high fever, sudden bleeding, hematemesis, internal bleeding, diarrhea, severe dehydration, shock, foreign bodies in ears, nose, throat, eyes, trachea, bronchus and esophagus, acute pain, redness or acute visual impairment, sudden, severe symptoms and dyspnea.

Inspection items that can be reimbursed by medical insurance card

1, using χ-ray computed tomography device, stereotactic radiation device, γ knife and χ knife.

2. The X-ray machine used for cardiac angiography includes digital subtraction equipment.

3. Magnetic resonance imaging equipment

4, single photon emission computer scanning device SPECT5, color Doppler instrument, medical linear accelerator and other large medical equipment inspection of medical items and individual costs more than 200 yuan times.

Medical insurance card reimbursement treatment project

1, extracorporeal shock wave lithotripsy, hyperbaric oxygen therapy, medical linear accelerator therapy, intensive care and rescue in CCU and ICU wards.

2. Kidney transplantation, heart valve transplantation, corneal transplantation, skin transplantation, blood vessel transplantation, bone transplantation, bone marrow transplantation and islet transplantation.

3. Replacement and installation of artificial organs in vivo, such as pacemakers, artificial joints, intraocular lenses, artificial larynx, artificial hip joints, etc. Cardiac bypass surgery and balloon dilatation of cardiac catheter.

4, hemodialysis, peritoneal dialysis

5. Cardiac laser drilling, anti-tumor cellular immunotherapy, interventional therapy and fast neutron therapy projects.

6, a single cost more than 200 yuan's diagnosis and treatment projects.

Legal basis:

People's Republic of China (PRC) social insurance law

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.