Is infertility covered by Medicare?

Infertility is not covered by forecast insurance and cannot be reimbursed.

The specific criteria are as follows:

While the scope of reimbursement may vary from one health insurance policy to another, it is usually limited to reimbursement of reasonable and necessary medical expenses actually incurred by the insured person due to illness or accident, and not reimbursement of maternity-related medical expenses, including labor and delivery, cesarean section, ectopic pregnancy, infertility and other infertility expenses, as well as complications due to maternity, are exempted.

What can be reimbursed by medical insurance:

1. Hospitalization: medical insurance can reimburse medical expenses for hospitalization due to illness or accident, including medical service fee, medicine fee, material fee, examination fee, etc.

2. Outpatient treatment: medical insurance can reimburse the medical expenses for outpatient treatment, including registration fee, consultation fee, examination fee, medicine fee, etc.

3. 3. Medical checkups: Medical insurance can reimburse individuals for medical checkups at their own expense.

It is important to note that regulations may vary from region to region and policy to policy, and the specific reimbursement scope and standard is subject to local policy.

Medical insurance reimbursement process:

1, confirm the scope of reimbursement: in the process of treatment, you need to confirm that their treatment items belong to the scope of reimbursement of medical insurance;

2, collection of reimbursement materials: collect the relevant records of treatment, drug receipts, medical cost lists and other related materials;

3, to the social security department to handle the reimbursement: submit the relevant materials to the local social security department for reimbursement;

3, to the local social security department for reimbursement.

4. Waiting for the audit: the social security department will carry out relevant audits and comparisons to confirm the reimbursement rate and reimbursement amount; receiving the reimbursement payment: after the audit is approved, you can receive the reimbursement payment of the medical insurance at the designated bank.

Summary, infertility health insurance is not able to reimburse, because it is a disease does not belong to the scope of health insurance reimbursement. Infertility is not reimbursed by Medicare. Infertility can be caused by a variety of factors, including tubal problems and inflammatory conditions. Therefore, it is best to consult in advance to find out the specific causes of their own, to find the cause of infertility, and then later on active medication or surgical methods of treatment, to achieve better results.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as emergency and salvage, shall be paid from the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.