Can abortion be reimbursed?

The specific criteria are as follows:

1. If it is commercial medical insurance, it is not allowed to reimburse the medical expenses incurred due to abortion, because commercial medical insurance can generally only reimburse the reasonable and necessary medical expenses incurred by the insured due to illness or accident, while if it is maternity-related medical expenses, including childbirth, caesarean section, abortion, ectopic pregnancy, infertility treatment and other fertility-related medical expenses, it belongs to the exemption scope of commercial medical insurance.

2. If it is basic medical insurance, because maternity insurance has been merged with basic medical insurance, it can actually be said that basic medical insurance can reimburse the medical expenses incurred by the insured due to childbirth, including the medical expenses incurred by the insured due to caesarean section. But the premise is that the insured person meets the conditions for enjoying maternity insurance benefits. For example, Changsha requires the insured to pay the basic medical insurance for 10 months in full before they can enjoy maternity insurance-related benefits.

Medical insurance reimbursement process in different places:

1, medical treatment in different places needs to be approved by relevant departments first. The examination and approval place for resettlement in different places is the county medical insurance center where the insured unit or street social security is located. After applying for the relevant approval form, fill in the relevant contents. Take the relevant documents to the medical insurance department of a different hospital and stamp them. Then return the relevant approval form to the applicant for approval;

2. The time limit for examination and approval in different places is generally one year, that is, from the date of handling to the date of the second year. You can't change it within a year. If the approval period has passed, the parties who are still in different places need to go to the relevant departments for re-approval. For the parties in different places, it is essential to choose a different hospital. The regulations on how many hospitals patients can choose in different regions are different. Generally, you can choose two or three;

3. It is essential for people who seek medical treatment in different places to meet reimbursement in different places. Relevant personnel need to go to outpatient department and hospital to issue receipts, lists, prescriptions, details, medical insurance manuals and case diagnosis certificates. The more detailed, the better. At the same time, don't forget to issue the registration certificate of the hospital where you go to see a doctor, so that employers, social security offices and district and county medical insurance centers can make statistical summary and audit settlement;

4. For the medical expenses incurred by the parties in designated hospitals in different places, mail the relevant reimbursement documents back to the original city for reimbursement, or ask family members to help with reimbursement in the original city. Issues such as reimbursement standards will still be in accordance with the regulations of the city, and relevant funds can be collected by family members or related accounts can be set up.

To sum up, the cost of abortion can be reimbursed, but according to everyone's medical insurance situation, some people may be, generally speaking, the reimbursement ratio of rural cooperative medical care is 800 or 1000, and another person has maternity insurance, so he will be reimbursed more, so generally speaking, it is recommended to go to your hospital for medical insurance.

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 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business 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.

"Trial Measures for Maternity Insurance for Enterprise Employees" Article 6

The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. Medical service fees and medicine fees, including self-funded drugs and nutritional drugs, which exceed the prescribed amount shall be borne by the employees themselves. After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund, and the medical expenses for other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs rest and treatment due to illness, it shall be handled in accordance with the relevant provisions on sick leave and medical insurance benefits.