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Can andropathy be reimbursed to the medical insurance card?
Legal analysis: it is different to have medical insurance or social security in rural areas if there is andropathy. Take rural cooperative medical insurance as an example: 1. Reimburseable1; Out-patient compensation: (1) 60% of medical treatment in village clinics and village center clinics; The cost limit of prescription drugs per visit is 10 yuan; And the prescription drug fee limit of temporary rehydration for doctors in hospitals is 50 yuan. (2) Reimbursement for medical treatment in town health centers is 40%. The limit of examination fee and operation fee for each visit is 50 yuan, and the limit of prescription drug fee is 100 yuan. (3) The reimbursement for medical treatment in secondary hospitals is 30%, and the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drug fee is 200 yuan. (4) 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan. (5) The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan. (6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan. 2. Reimbursement scope of hospitalization compensation (1): A. Drug expenses: auxiliary examination: various examination expenses such as electrocardiogram, X-ray, radiography, laboratory test, physiotherapy, acupuncture, CT, nuclear magnetic resonance, etc. 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). B, the elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan. (2) Reimbursement ratio: town hospitals reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%. 3. Compensation for Serious Illness (1) Town Risk Fund Compensation: Where the medical expenses of inpatients participating in rural cooperative medical insurance exceed 5,000 yuan at one time or cumulatively throughout the year, they should be compensated by stages, that is, 500 1- 10000 yuan is 65%,1kloc-. (2) The annual compensation limit for hemodialysis, radiotherapy and chemotherapy in the town-level cooperative medical system inpatient and uremia clinic is1.65,438+0.000 yuan. Second, it is not reimbursed, and the following are not included in the reimbursement scope of rural cooperative medical insurance: 1, self-seeking medical treatment (no designated hospital for medical treatment or no referral form), self-purchased drugs, drugs that cannot be reimbursed according to the provisions of free medical care, and medical expenses that do not meet the requirements of family planning; 2, outpatient treatment fees, visits, hospitalization fees, meals, escort fees, nutrition fees, blood transfusion fees (except for family blood storage, according to the relevant provisions of reimbursement), heating and cooling fees, ambulance fees, allowances and other expenses; 3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents; 4. Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc. ; 5, within the scope of reimbursement, beyond the limit.
Legal basis: Article 29 of the Social Insurance Law of People's Republic of China (PRC) stipulates that the medical expenses incurred by the insured shall be paid by the basic medical insurance fund and directly settled by social insurance agencies, medical institutions and pharmaceutical trading units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
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