Kidney calculi's compensation

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

2. There are drug lithotripsy, extracorporeal lithotripsy and surgical lithotripsy in kidney calculi. Only surgical stone removal 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.

Extended data:

The scope of reimbursement for social security medical care:

1. Generally, Class A drugs can enjoy full coverage, Class C drugs need to be paid at their own expense, and Class B drugs need to report 80% and pay 20%.

2. Not in medical insurance coverage:

(1) Among the special medical expenses, the expenses for organ and tissue transplantation due to illness, organ and tissue purchase, and the expenses for using anti-rejection drugs and immunomodulatory drugs beyond the scope of medical insurance reimbursement for employees in Zhenjiang;

(2) Work-related injuries and occupational diseases;

(3) Maternity of female employees;

(4) hooliganism;

(5) Harm caused by alcoholism;

(6) Traffic accidents;

(7) intentional injury by others;

(8) Medical accidents;

(9) beauty and health examination;

(10) Other expenses not paid by the social medical insurance fund.

3, the insured workers on business trips, visiting relatives in the field of medical expenses, only meet the requirements of medical insurance reimbursement of emergency expenses in the field, non emergency reasons for hospitalization, all expenses will not be reimbursed.

4, the insured workers living in the field for more than 6 months, according to the nature of long-term living in the field of medical expenses.

5. Long-term residents in other places shall be certified by the unit, and two designated hospitals (local medical insurance designated medical institutions) shall be identified, and the medical expense reimbursement card for long-term residents in other places in Zhenjiang City shall be handled in time.

6. Employees who live in other places for a long time must adhere to the principle of economy and prescribe drugs in limited quantities according to regulations. Those who exceed the above standards will not be reimbursed for medicine.

7, long-term resident workers referral, signed by the local designated hospitals, according to the principle of territoriality referral step by step.

8. Designated hospitals: the individual pays 65438+ 00% of the total expenses first, and then reimburses the expenses according to the medical insurance regulations; In other hospitals, individuals pay 20% of the total expenses first, and then reimburse medical expenses according to medical insurance regulations.

References:

Baidu encyclopedia-medical insurance coverage