Why is there no medical insurance reimbursement for Chinese medicine?

Traditional Chinese medicine can be reimbursed if it is included in the basic medical insurance drug list. The reasons for non-reimbursement may be: not included in the drug list; Not included in the basic medical insurance fund payment scope.

Medical insurance reimbursement categories and supporting materials:

1. Transfer for medical treatment: If it is really necessary to transfer for medical treatment, if the condition is urgent, the formalities should be completed within 7 days of transfer and admission;

2. Resettlement and work in different places: if you want to live and work in different places for more than half a year, you must go through the registration formalities in advance;

3. Medical expenses during short-term outings such as business trip, visiting relatives and traveling: ① Acute illness: providing business trip certificate, visiting relatives certificate, travel contract, air ticket to real-name registration system, etc. At the time of reimbursement; (2) outpatient maintenance treatment of chronic diseases: the medical records of Xiamen should be increased, and the measures of diagnosis and treatment should not exceed that of Xiamen;

4. Off-site delivery: hospitalization delivery expenses and reasonable prenatal and postpartum examination expenses;

5. Failures of social security system in local and urbanized areas cannot be settled in real time by credit cards: the invoices of the charging offices of medical institutions should be endorsed and stamped;

6. The social security card is reported lost or damaged, and the printing of the business card is delayed: the back of the invoice of the social security card management department is stamped for confirmation;

7. The number of outpatient visits in a single month exceeds 20: the bill must be settled by credit card and show the number of registered visits, and outpatient records must be provided;

8. Acute illness or rescue without social security card: the medical records of outpatient or inpatient should be detailed and clear enough to be identified as acute illness or rescue;

9. Off-catalogue drug expenses of retired cadres: An Approval Form for Off-catalogue Drugs of Retired Cadres should be provided and stamped with the official seal of the hospital medical insurance management department; The retired cadres entrusted by the provincial two-level charging center should provide health care certificates;

10. Enrolment status, change, change of insured unit and delay in receiving local tax data: reimbursement can be made after the local tax change is confirmed in the middle of the next month;

1 1. Medical expenses of newborns from birth: they should be insured within three months of birth and paid in time, and can only be reimbursed after receiving the money. Need a birth certificate; For the unnamed newborn at the time of expense, the name on reimbursement vouchers such as medical expense invoices, summary tables and discharge records should be the name of the mother or father followed by "son" or "daughter".

In summary, the medical expenses shall be borne by the 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.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 30

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

1, which shall be paid from the industrial injury insurance fund;

2, should be borne by a third person;

3, should be borne by public health;