Is kidney calculi gravel medical insurance reimbursed?

1, kidney calculi is the basic medical insurance. You can apply for medical insurance hospitalization, but not all expenses are reimbursed.

2. There are medical lithotripsy, extracorporeal lithotripsy and surgical lithotripsy in kidney calculi, of which only surgical lithotripsy can be reimbursed, and the other two are outpatient treatment and cannot be reimbursed.

3, medical insurance hospitalization reimbursement, in addition to their own expenses, class B expenses paid in advance 10%, more than the deductible part can be reimbursed.

4. When hospitalized in a designated medical insurance hospital, issue a medical insurance card so that the unified medical insurance settlement system can read the information of the insured person and handle the hospitalization number. At the time of discharge settlement, the medical insurance system does not charge the overall payment part of reimbursement.

(a) the scope of medical insurance reimbursement:

1, general outpatient service fees, outpatient service fees and emergency service fees of eligible medical institutions;

2, designated medical institutions general ward bed fee;

3, outpatient decocting fee;

4, designated medical institutions for medical treatment, dispensing or retail pharmacies dispensing medical expenses;

5, in line with the basic medical insurance treatment project, medical service facilities, medication scope and payment standard of medical expenses.

(two) the proportion of medical insurance reimbursement:

1. outpatient and emergency medical expenses: the accumulated medical expenses of employees who meet the medical insurance requirements for one year in a row have reached more than 2,000 yuan;

2. Settlement ratio: 50% of the part of the dispatched personnel that reaches more than 2,000 yuan during the contract period will be reimbursed, and the remaining 50% will be borne by the individual; The maximum reimbursement for outpatient and emergency services paid by dispatched personnel within one year is 20,000 yuan;

3, the insured must keep the medical documents of designated medical institutions, as reimbursement vouchers;

4. Outpatient treatment of three kinds of special diseases: when the insured suffers from malignant tumor, chemotherapy, renal dialysis, kidney transplantation and other diseases and needs to take anti-rejection drugs in outpatient treatment, he must ask the hospital to issue a "disease diagnosis certificate", fill in the "medical insurance special disease declaration and approval form" and report it to the local medical insurance center for approval and filing. These three special diseases can only be settled after diagnosis and treatment in designated hospitals.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 30

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance.

After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Article 25

The state establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 23