Can Huaxia Medicare reimburse the cost of the intensive care unit?

Social health insurance reimbursement is reimbursed after discharge or transfer. Settlement procedures for inpatient and special disease outpatient clinics**: Before the 10th of each month, the designated medical institutions shall report the cost statement, hospitalization statement and relevant information of the discharged patients in the previous month to the medical insurance agency, and the medical insurance agency will review and use it as the basis for monthly advance allocation and year-end accounts; The medical insurance agency pre-allocates the overall expenses of the previous month's inpatient and special disease outpatient clinics** every month; Insured persons who have been identified as suffering from special diseases shall go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines, and the medical expenses incurred shall be directly billed and settled immediately.

China Diagnosis Settlement Procedure: Insured persons due to China Diagnosis and Rescue to the city's non-designated medical institutions and other medical institutions hospitalized**, the medical expenses incurred shall be paid in advance by the individual or unit, and after the end of the China Diagnosis and Rescue, the medical records of the hospital, examination, laboratory reports, invoices, and detailed medical charges shall be handled by the medical insurance agency according to the regulations. Settlement procedures for resettlement personnel:

The resettlement of non-local staff shall be designated by their units to 1-2 designated medical institutions in their places of residence, and reported to the medical insurance agency for the record; The medical expenses incurred by the staff in the designated medical institutions in the place of residence shall be paid in advance by the person or the unit concerned, and after the end of the meeting, the unit shall hold the medical certificate and medical records of the insured personnel, valid expense bills, compound prescriptions, and a list of hospitalization expenses to the social medical insurance agency on the specified date for settlement.

The policies of each company are different, so the regulations are different.

The following are not covered by the reimbursement of rural cooperative medical insurance:

1. Self-medical treatment (no designated hospital for medical treatment or no referral form), self-purchased drugs, drugs that cannot be reimbursed by publicly-funded medical regulations, and medical expenses that do not meet the requirements of family planning;

2. Outpatient fees, house visit fees, hospitalization fees, food expenses, accompanying fees, nutrition fees, blood transfusion fees (except for those with family blood storage, which will be reimbursed according to relevant regulations), air conditioning and heating fees, ambulance fees, special nursing fees and other expenses;

3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents;

4. Orthopedics, plastic surgery, dental prosthesis, prosthesis, organ transplantation, roll call surgery fees, consultation fees, etc.;

5. Within the scope of reimbursement, the part outside the limit.

Hospital intensive care unit expenses fall into the second category and are therefore not reimbursable.

Social medical insurance reimbursement hospital or transfer reimbursement inpatient and special disease outpatient ** settlement procedures: Designated medical institutions shall report to the medical insurance agency for review and approval of the medical insurance agency according to the monthly patient expense statement, hospitalization statement and relevant information in the month before 0 for the monthly pre-allocation and final accounting; The medical insurance agency pre-allocates monthly inpatient and special disease outpatient expenses** overall expenses; Insured persons who are identified as suffering from special diseases should be directly billed and settled by the designated medical institutions designated by the labor and social security department for medical purchases and medical expenses China Diagnosis and Settlement Procedures: Insured Persons in China Diagnosis and Rescue Hospitalization in non-designated medical institutions and different medical institutions in the city ** Medical expenses shall be paid in advance by the unit at the end of the China Diagnosis and Rescue with the medical records, examinations, laboratory reports, invoices, detailed medical charges and other medical insurance agencies in accordance with the provisions of the reimbursement procedures for the settlement procedures of different resettlers:

Workers who are resettled in different places shall be designated by their units and designated by their designated medical institutions and reported to the medical insurance agency for the record; The medical expenses issued by the designated medical institutions and clinics where the workers are sick and resided shall be paid in advance by the unit or the unit** The end shall be settled by the social medical insurance agency with the medical certificate and medical records of the insured, the effective expense bills, the duplex office, the list of hospitalization expenses, etc.

ICU intensive care expenses, according to the actual required items, can be reimbursed by medical insurance in the medical insurance reimbursement catalog, and those that do not fall within the scope of medical insurance reimbursement are not reimbursed. The items that can be reimbursed by ICU include ECG monitoring fees, ventilator usage fees, injection fees, diagnosis and treatment fees, etc., which are in the reimbursement list of medical insurance. If the imported drugs used are not included in the medical insurance reimbursement list, they will not be reimbursed.

The medical insurance catalogue is regulated by the local social security bureau.

Taking Zhengzhou as an example, according to Article 23 of the Measures for Basic Medical Insurance for Urban Residents in Zhengzhou (Trial), newly insured residents who pay basic medical insurance premiums on time and in full shall have a waiting period of 3 months for the treatment of inpatient medical insurance and outpatient prescribed diseases, and the waiting period shall be calculated from the first month of the effective date of basic medical insurance. The medical expenses incurred during the waiting period shall be borne by the individual and will not be paid by the co-ordination**.

Article 34 The list of drugs, the list of diagnosis and treatment items, the scope of medical service facilities and the payment standards of the residents' medical insurance shall be formulated separately by the municipal labor and social security department. Medical expenses beyond the scope of the catalogue will not be paid by the co-ordination**.

Article 35 The part of the inpatient medical expenses incurred by insured residents in designated medical institutions shall be paid by the individual in cash or personal account; The part that should be paid by the co-ordination ** shall be billed by the designated medical institutions.

Social health insurance.

BAI reimbursement is reimbursement after discharge or transfer.

Settlement procedures for inpatient and special disease DAO outpatient clinics**.

Before the 10th of each month, the designated medical institutions shall report the cost statement, hospitalization statement and relevant information of the discharged patients in the previous month to the medical insurance agency, and the medical insurance agency shall review and approve it as the basis for monthly pre-allocation and year-end accounts;

The medical insurance agency pre-allocates the overall expenses of the previous month's inpatient and special disease outpatient clinics** every month;

Insured persons who have been identified as suffering from special diseases shall go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines, and the medical expenses incurred shall be directly billed and settled immediately.

Emergency settlement procedures: insured personnel due to emergency rescue to the city's non-designated medical institutions and non-local medical institutions hospitalized**, the medical expenses incurred, first paid by the individual or unit, after the end of the emergency rescue, with the hospital emergency medical records, examinations, laboratory reports, invoices, detailed medical charges to the medical insurance agency according to the provisions of the reimbursement procedures.

Settlement procedures for resettlement personnel:

The resettlement of non-local staff shall be designated by their units to 1-2 designated medical institutions in their places of residence, and reported to the medical insurance agency for the record;

The medical expenses incurred by the staff in the designated medical institutions in the place of residence shall be paid in advance by the person or the unit concerned, and after the end of the meeting, the unit shall hold the medical certificate and medical records of the insured personnel, valid expense bills, compound prescriptions, and a list of hospitalization expenses to the social medical insurance agency on the specified date for settlement.

ICU intensive care unit, often seen on TV, when a person is very sick and needs to be rescued, they will be sent to the ICU, and the patient will receive first aid measures after entering the ICU, which is why it is expensive.

Reimbursement, taking Beijing as an example.

Beijing Municipal Measures for Basic Medical Insurance for Urban Residents have corresponding provisions on it:

19th insured persons in line with the city's basic medical insurance and student and children's serious illness medical insurance drug catalog, diagnosis and treatment items catalog, medical service facilities within the scope of medical expenses, by the urban residents of the basic medical insurance ** according to the provisions of the payment. Includes:

1) Outpatient (emergency) medical expenses;

2) Medical expenses for hospitalization**;

3) Outpatient medical expenses for radiation and chemistry of malignant tumors, kidney dialysis, kidney transplantation, liver transplantation (including liver-kidney combined transplantation) followed by anti-rejection drugs, hemophilia, and aplastic anemia.

Hospital intensive care unit expenses are not covered by Medicare.

The following are not covered by the reimbursement of rural cooperative medical insurance:

1. Self-medical treatment (no designated hospital for medical treatment or no referral form), self-purchased drugs, drugs that cannot be reimbursed by publicly-funded medical regulations, and medical expenses that do not meet the requirements of family planning;

2. Outpatient fees, house visit fees, hospitalization fees, food expenses, accompanying fees, nutrition fees, blood transfusion fees (except for those with family blood storage, which will be reimbursed according to relevant regulations), air conditioning and heating fees, ambulance fees, special nursing fees and other expenses;

3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents;

4. Orthopedics, plastic surgery, dental prosthesis, prosthesis, organ transplantation, roll call surgery fees, consultation fees, etc.;

5. Within the scope of reimbursement, the part outside the limit.

Hospital intensive care unit expenses fall into the second category and are therefore not reimbursable.

The reimbursement ratio of medical insurance ICU in hospitals in Guangdong Province is: hemodialysis and peritoneal dialysis, with a maximum rate of 90%. A maximum of 50% of artificial organs and endoplastic materials are placed. Human organ transplant (kidney transplant, etc.) The maximum reimbursement rate is 70%.

As long as the condition allows and the designated hospitals are covered by the medical insurance, they can be reimbursed. Or emergency hospitalization within one week can be reimbursed.

Yes But it depends on what medicine.

The reimbursement scope of Huaxia Medical Insurance Pass is as follows:

1.Inpatient and special outpatient expenses.

2.Examinations, surgeries, nursing, imported medicines, self-paid medicines, etc., are all reimbursable.

3.It can only be reimbursed in public hospitals above the second level, and it must be confirmed before seeking medical treatment.

The specific coverage is as follows:

1. The flagship version, there is an insurance amount of 2 million for general inpatient medical treatment, and the minimum deductible is 5,000; 100 types of critical illness medical insurance amount of 4 million, 0 deductible; Medical expenses can be paid in advance, including the first 7 days and the last 30 days of hospitalization and emergency expenses; covering 56 kinds of purchased drugs for 2 million; Proton heavy ion guarantee fund of 1 million yuan, reimbursement 100%.

2. Flagship Enhanced Edition, guaranteed renewal for 6 years, general hospitalization has an insured amount of 2 million, and a minimum deductible of 5,000; 100 types of critical illness medical insurance amount of 4 million, 0 deductible; Includes the first 7 days and the last 30 days of inpatient outpatient and emergency expenses; covering 80 kinds of purchased drugs and 2 million; Proton heavy ion guarantee fund of 1 million yuan, reimbursement 100%.

3. Inclusive version, the insurance amount of 2 million for general inpatient medical treatment, with a minimum deductible of 5,000; 100 types of critical illness medical insurance amount of 4 million, 0 deductible; Includes the first 7 days and the last 30 days of inpatient outpatient and emergency expenses; Proton heavy ion guarantee fund of 1 million yuan, reimbursement of 60%.

4. Special drug version, 56 kinds of anti-cancer drugs have an insurance amount of 2 million and 0 deductibles

5. Anti-cancer version, cancer insurance amount of 2 million, 0 deductible; Including cancer diagnosis expenses, the first 7 days, the next 30 days of hospitalization and emergency expenses; Proton heavy ion guarantee fund of 1 million yuan, reimbursement of 60%.

Question: 2018 version of Huaxia Ping An Fu Medical Insurance Pass, I want to have slight bone hyperplasia, lumbar intervertebral disc wants to be hospitalized for physiotherapy, can the medical insurance pass be reimbursed?

The insurance company will reimburse you, accurate and tasteful, I will not confirm it, and I will not deceive people, as long as it is precious to the insurance company, it is all prescribed by law.

This requires you to pay the insurance coverage at that time, and the compensation you want to deal with.

Shortcomings, it's hard to talk about. Because of one problem, it is possible that all insurance companies will have similar products. The positioning of this product is a supplement to large-scale inpatient medical treatment.

Such products generally have to look at the issue of deductible. Because it involves social security drugs and self-paid drugs, if there is 0 deductible,

If it is an emergency illness that is too far away from the second-level or above doctor, choose the nearest second-level hospital and how to report it.

Huaxia Insurance's coverage includes inpatient medical expenses and special outpatient expenses. Expenses such as examination fees, diagnosis and treatment fees, bed fees, surgery fees, nursing fees, imported drugs, self-financed drugs, radiotherapy and chemotherapy can be reimbursed. It should be noted that the expenses incurred in public hospitals of the second level and above can be reimbursed, and they should be confirmed before seeking medical treatment.

ICU intensive care expenses, according to the actual required items, can be reimbursed by medical insurance in the medical insurance reimbursement catalog, and those that do not fall within the scope of medical insurance reimbursement are not reimbursed. The items that can be reimbursed by ICU include ECG monitoring fees, ventilator usage fees, injection fees, diagnosis and treatment fees, etc., which are in the reimbursement list of medical insurance. If the imported drugs used are not included in the medical insurance reimbursement list, they will not be reimbursed.

The medical insurance catalogue is regulated by the local social security bureau.

The proportion of medical insurance reimbursement for ICU and intensive care unit is different, depending on what kind of drug you use? The general reimbursement rate is about 10%.

The one has to be consulted first, and some have to be declared before they can be reimbursed.

When my dad was in the ICU ward last year, because it was within the scope of medical insurance, he directly underwrote [the part that can be reimbursed was reduced].

The ICU can't afford to live every day, so you can transfer it out when you can transfer it to the general ward, and there are more opportunities for the general ward and your loved ones.

Only 50 a day's expenses are reimbursed, and most of them are not reimbursed.

What is the reimbursement ratio of medical insurance for living in the intensive care unit of Beijing Sanyu Hospital?

ICU stands for "Intensive Care Unit", ICU beds.

Figuratively known as "the most expensive bed in life", the cost of a one-day ICU stay in a tertiary hospital is currently about 10,000 yuan.

So, why are ICUs so expensive? I've put together the most common expenses as follows:

Let's go straight to the conclusion:

When treating critically ill patients, these devices may be used at the same time, and it seems that the unit price per hour and each time is not expensive, but at the end of the day, the cost is like water.

Insurance isn't a necessity of life, but everyone who has been to an ICU knows how important insurance is.

Insurance is divided into national medical insurance and commercial insurance, and the reimbursement of the two is different.

1. How much can I get covered for medical insurance?

Medical insurance is available to almost everyone, whether it is an ICU or a general ward, and the expenses are reimbursed according to the three major medical insurance catalogs.

The three major catalogs of medical insurance include: drug catalog, diagnosis and treatment catalog, and service facility catalog.

I take the diagnosis and treatment directory in Guangdong as an example:

Let's go straight to the conclusion:

Medical insurance will reimburse part of the medical expenses, but it is difficult to reimburse them all, especially for some high-cost **, which is basically not 100% reimbursed.

For example, a patient admitted to the ICU due to heart failure needs to pay 100,000 yuan out of pocket to install a pacemaker, but the medical insurance can only reimburse 50,000 yuan, and the remaining 50,000 yuan has to pay out of pocket.

In addition, in terms of medication, many special drugs and imported drugs commonly used in ICU cannot be reimbursed by medical insurance.

2. How much can I get for commercial insurance?

Commercial medical insurance is an effective supplement to medical insurance, especially the "million medical insurance" has a reimbursement amount of 2 million to 3 million yuan per year, in case you are unfortunate enough to enter the ICU, at least you don't have to worry about money.

As long as it is a "reasonable and necessary" expense, the medical insurance can cover the million-dollar medical insurance, such as the normal medication of the ICU, as well as the use of artificial lungs and artificial kidneys mentioned earlier.

However, some expensive drugs may not be available in the hospital, and you may need to buy them outside, so not all medical insurance can be covered at this time.

In addition, the advance payment is also a very practical function, after all, there are not many families who can come up with a large amount of cash.

For critically ill patients, these two functions are very practical and recommended that you pay attention to them.

3. Remember to apply for serious illness subsidy

When I watched some documentaries, I found that some doctors will take the initiative to apply for ** subsidies for patients.

Later, I learned that many places have subsidy policies for serious illnesses.

This subsidy is mainly aimed at:Poor families, generally have tens of thousands of yuan, you can consult the local civil affairs bureau for details

In addition, there are some charity meetings, you can ask more, and you can also solve some urgent needs at critical moments.

ICU is the place where human nature can be best reflected, and "to cure or not to cure" is a torture that goes deep into the soul.

In addition to the huge pain suffered by the patient, the high cost can also overwhelm most families at any time; Death, giving up the last hope of a loved one, may leave a lifetime of regret.

No one wants to go to the ICU, but in the unlikely event that misfortune strikes, hopefully insurance will give you a bit of courage.