How much is the medical insurance reimbursement for appendicitis?

The normal situation of medical insurance reimbursement for appendicitis will reach 60%-70%, depending on where you are hospitalized and the medication situation.

Appendicitis is a common and frequently-occurring disease in general surgery, which can be divided into acute appendicitis and chronic appendicitis according to the course of disease. This disease is not very serious, and medical insurance can reimburse it. Whether it is urban medical insurance, employee medical insurance or small commercial medical insurance, it can be reimbursed. It should be noted that urban medical insurance and employee medical insurance can only reimburse drugs used by social security, and they are reasonable and necessary medical expenses, while some small commercial medical insurance can reimburse drugs at their own expense.

Medical insurance refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection.

The basic medical insurance fund consists of overall funds and individual accounts. The basic medical insurance premiums paid by individual employees are all included in individual accounts; The basic medical insurance premium paid by the employer is divided into two parts, one part is included in the personal account, and the other part is used to establish the overall fund.

Personal account of medical insurance is a special account established according to the basic medical insurance policy, which is specially used to store the medical insurance premiums paid by the insured and the funds allocated by the employer according to a certain proportion, and record the medical consumption. The funds in the personal account are used to pay for the out-of-pocket part of medical treatment and medicine purchase.

Medical insurance has been popularized throughout the country, mainly in the following three aspects:

First, solve it at different levels. Ministry of Human Resources and Social Security confirmed that the problem of medical treatment in different places will be solved step by step by combining the promotion of the gold insurance project and the issuance of social security cards.

Second, the Ministry and the province are connected. China's national labor and social security network has realized the networking of all provinces, and the networking of provinces and cities has been completed over 90%; Medical insurance information systems in various places are gradually being unified, and nearly 400 cities across the country have used the core application software of China National Medical Insurance Information System I. The construction of social security cards is being vigorously promoted; The construction of departmental off-site medical expense settlement platform is under way, and the technical conditions for nationwide networking of medical insurance are gradually available.

Third, authentication in different places. Ministry of Human Resources and Social Security is promoting the authentication system to assist people in different places to receive social insurance benefits. Telephone consultation service centers, internet service channels and community information platforms are also being accelerated, and the service modes of "living in different places, direct settlement" and "calling from one place and consulting all over the country" are gradually realized.

If the employer fails to pay social insurance premiums in full and on time in accordance with Chinese laws, the social insurance premium collection agency shall order it to pay within a time limit or make up for it. If the employer fails to pay the social insurance premium in full and fails to provide guarantee, the social insurance premium collection agency may apply to the people's court for sealing up, distraining and auctioning the property whose value is equivalent to the social insurance premium that should be paid, so as to offset the social insurance premium with the proceeds from the auction. The collection agency of the personal payment information base fee on the social security account shall order it to pay or make up within a time limit.

legal ground

Social Insurance Law of People's Republic of China (PRC) (revised on 20 18).

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.