Can you get reimbursed by health insurance for having an abortion?

An abortion can be reimbursed by health insurance.

Whether the cost of an abortion can be reimbursed with a health insurance card depends on local health insurance policies and the nature of the procedure. In general, abortion surgery as a medical service can be paid for with a medical insurance card if it meets the relevant provisions of the basic medical insurance. If the cost of the procedure exceeds the funds in the individual account, the additional costs incurred may be reimbursed at a certain percentage. However, abortion is not covered by maternity insurance and therefore cannot be reimbursed through maternity insurance. In addition, health insurance policies may vary from region to region, so it is recommended that you consult your local social insurance agency for specific reimbursement conditions and procedures before the procedure. If the surgery was performed in a public hospital and the patient is eligible for reimbursement, the patient can apply for reimbursement from their organization with the hospital invoice.

The scope of reimbursement of medical insurance:

1, the basic principle of reimbursement of medical insurance: medical insurance reimbursement usually follow the principle of reasonable and necessary, aiming to reduce the financial burden of the insured person due to illness;

2, medical services reimbursed by medical insurance: including outpatient treatment, inpatient treatment, drug costs, diagnostic and therapeutic program costs;

3, medical insurance reimbursement of special Maternity insurance may be included in some regions, covering women's childbirth and related medical services;

4. Limitations on reimbursement: reimbursement rates, thresholds, and ceilings vary by region and policy;

5. Approval process for reimbursement: some special treatments or high-cost medical expenses may require prior approval or after-action review.

In summary, whether the cost of abortion can be reimbursed through medical insurance depends on the local medical insurance policy and the nature of the procedure. Usually, the cost of abortion that meets the requirements of the basic medical insurance can be paid for with the medical insurance card, and the excess may be partially reimbursed, but it is not included in the maternity insurance. Patients are advised to consult their local social security agency in advance for details and to apply for reimbursement from their organization when the procedure is performed in a public hospital and the conditions are met.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 28

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.