Enteroscopy gastroscopy have health insurance

Colonoscopy gastroscopy is generally covered by Social Security, and gastroenteroscopy is a more accurate test used to examine patients for gastrointestinal disorders.

The cost of medication needed for a gastroenteroscopy is covered by social security, but the anesthesia required for a painless gastroenteroscopy is partially covered by out-of-pocket expenses, which can be reimbursed at around 500 yuan, and is available at tertiary hospitals. Urban medical reimbursement mainly refers to hospital visits, medication, hospitalization, surgery, etc., which can be reimbursed through social security cards in accordance with the relevant provisions of the medical expenses. Urban medical insurance is more specialized, the size of the project and coverage, but it is limited in major diseases or accidents, participants can separately purchase commercial major medical insurance and social security for a combination of ways to reduce their financial losses.

Medical insurance coverage:

1, basic medical insurance drug reimbursement

Our country now classifies drugs into three categories, namely A, B and C, of which Category A drugs are within the scope of medical insurance, so only Category A drugs can be reimbursed by the medical insurance, while Category B and C can not be reimbursed;

2, the reimbursement of basic medical services

This is the main purpose of the reimbursement of basic medical services.

This reimbursement scope mainly refers to the insured person, in the medical insurance designated institutions for diagnosis and treatment and nursing care, in the process, the incurred bed fee, emergency bed fee, consulting fees and so on;

3, the basic medical insurance reimbursement of diagnosis and treatment items

Must be safe and effective diagnosis and treatment, the charges are determined by the price department. You need to be treated in a designated medical institution.

Medical insurance reimbursement process:

1, in the medical insurance designated hospitals

Every city will have medical insurance designated hospitals, only in the medical insurance designated hospitals inside the diagnosis and treatment, only to be able to use the medical insurance to reimbursement. So if you want to use the medical insurance, you must go to the medical insurance designated hospitals, and to handle the relevant registration procedures;

2, ready to discharge information

In the discharge of the hospital in advance to the discharge of information to prepare, such as the diagnosis of the disease, the discharge record and the medical record, and so on. The doctor will help us to prepare these documents if we tell him that we need them during the treatment, and it is better to make a copy of these documents after you get them. One copy will be submitted to the medical insurance reimbursement office, and the other copy will be kept as a backup;

3. Discharge settlement

Take the hospitalization list and the invoice, and go through the settlement procedures in the hospital. After that, you can bring the relevant information to the medical insurance reimbursement department to reimburse and audit;

4, wait for the reimbursement of expenses to the account

When the information has been handed over, you will receive a receipt, and the reimbursement amount will be within 15 days to the account, you just need to wait patiently.

In summary, medical insurance covers the cost of gastroenteroscopy, but the painless gastroenteroscopy portion is paid for out of pocket.

Legal basis:

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

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency and rescue, will 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.