My son is 6 years old, he has strabismus, and he needs to be hospitalized for 5 days for surgery, an

Legal Analysis: No. Strabismus surgery is not covered by medical insurance, which is stipulated by the Health Insurance Bureau.

Legal basis: "Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers" Article 41 The provincial labor and social security administrative department shall, in accordance with the relevant provisions of the state, determine the list of basic medical insurance drugs in conjunction with the planning, economic and trade, financial, health administration and drug supervision and administration departments. The provincial labor and social security administrative department shall, in accordance with the relevant provisions of the state, determine the basic medical insurance diagnosis and treatment project catalog, the scope of medical service facilities and the payment standard in conjunction with the planning, finance, health administration and drug supervision and administration departments.

The use of drugs, diagnosis and treatment items, and medical service facilities that are not included in the scope of basic medical insurance shall not be paid for the overall planning of their expenses.

Hello, according to your question, the consultant Xiaoqing teacher is as follows1Before strabismus surgery, you still can't participate in medical insurance reimbursement, because strabismus surgery, at present, the state still considers it to be cosmetic corrective surgery, just like laser ** myopia, double eyelid surgery and other plastic surgeries are classified as cosmetic corrective surgery, or can not participate in medical insurance reimbursement. 2.

However, judging from the current development trend, the country may slowly include strabismus surgery in medical insurance reimbursement, because there are many children with congenital esotropia or exotropia, or other non-common strabismus, strabismus is very serious affecting visual function and vision, and may even lead to lifelong blindness. Therefore, the state may slowly include strabismus surgery in medical insurance.

Legal analysis: The reimbursement standard of medical insurance is related to the specific disease type and ** plan, and it is necessary to check the local medical insurance policy specifically.

Legal basis:1Article 14 of the Medical Insurance Law of the People's Republic of China stipulates that medical insurance** shall pay medical expenses for insured persons in accordance with the prescribed medical expenses and payment standards.

2.Article 14 of the Regulations of the People's Republic of China on Medical Insurance stipulates that the medical expenses paid by medical insurance** shall comply with the provisions of the medical insurance project.

3.The "Catalogue of Medical Insurance Drugs of the People's Republic of China (2019 Edition)" contains detailed surgical items and corresponding reimbursement standards.

Conclusion: It is necessary to check the local medical insurance policy to determine whether the surgery is covered by the medical insurance catalogue and the specific reimbursement criteria.

Legal Analysis: No. Strabismus surgery is not covered by medical insurance, which is stipulated by the Health Insurance Bureau.

Legal basis: "Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers" Article 41 The provincial labor and social security administrative department shall, in accordance with the relevant provisions of the state, determine the list of basic medical insurance drugs in conjunction with the planning, economic and trade, financial, health administration and drug supervision and administration departments. The provincial labor and social security administrative department shall, in accordance with the relevant provisions of the state, determine the basic medical insurance diagnosis and treatment project catalog, the scope of medical service facilities and the payment standard in conjunction with the planning, finance, health administration and drug supervision and administration departments.

For the use of drugs, diagnosis and treatment items, and medical service facilities that are not included in the scope of basic medical insurance return insurance, the cost of the overall planning base shall not be paid by Shixian.

Strabismus surgery does not fall within the scope of medical insurance reimbursement, but whether it is covered by commercial insurance depends on the specific type of insurance insured, if it is a commercial medical insurance.

As long as the insured visits the hospital and the expenses incurred comply with the terms and conditions, they can be reimbursed; If you are insured with critical illness insurance, cancer prevention insurance, etc., the insurance company will not reimburse you.

The reimbursement scope includes the reimbursement of drugs and the reimbursement of medical items.

The drugs within the scope of basic medical insurance payment are divided into class A and class B, and class A drugs refer to drugs that are basically unified across the country and can ensure the basic needs of clinical practice. The cost of drugs is included in the basic medical insurance** and is paid according to the basic medical insurance payment standard.

The list of Class B drugs is adjusted by the provinces, autonomous regions and municipalities directly under the Central Government according to their own conditions, and such drugs are first paid by employees for a certain percentage of the cost, and then included in the scope of basic medical insurance, and paid according to the standard of basic medical insurance.

2. Reimbursement of basic medical insurance diagnosis and treatment items.

The scope of diagnosis and treatment items paid by basic medical insurance is determined in accordance with the scope of diagnosis and treatment items of basic medical insurance stipulated by the state. Belong to the basic medical insurance payment department Cong friends within the cost of diagnosis and treatment items within the catalog, first by the insured according to the prescribed proportion of self-payment, and then according to the provisions of the basic medical insurance payment. If it is within the list of diagnosis and treatment items that are not paid by the basic medical insurance for employees, the basic medical insurance for employees will not be paid.

3. Reimbursement for basic medical service facilities.

The reimbursement of medical service facility expenses of basic medical insurance covers the life service facilities provided by designated medical institutions and necessary for insured persons in the process of receiving diagnosis, ** and nursing, mainly including inpatient bed fees or outpatient (emergency) observation bed fees.

Tips: To sum up, the reimbursement of drugs within the scope of medical insurance reimbursement in southern Qiannan is divided into two categories: A and B, all of which are within the scope of reimbursement, and Class B is within the scope of reimbursement after paying a certain percentage of expenses. Reimbursement and reimbursement for medical programs can be divided into objectives for medical programs, allowing for payment of expenses, allowing for partial reimbursement of expenses, and not paying for expenses.

The cost of surgery for pediatric oblique deceleration is related to the following factors:

1. How much does strabismus surgery cost for children? The cost of surgery depends on the degree of strabismus.

The cost of different strabismus patients will also vary, and it cannot be generalized, but it is related to the degree of strabismus of the patient.

It is understood that the surgical plan is calculated according to the degree of a person's strabismus, the abnormal extraocular muscles that need to be corrected, the strabismus surgery is roughly more than 4,000 yuan in one eye, and the specific fluctuation is mainly related to the degree of strabismus of the patient. In addition to the cost of strabismus surgery, the cost of routine preoperative outpatient examination is about a few tens of yuan to 100 yuan.

2. The first class of strabismus surgery is also reflected in medical equipment.

Dr. Guangming, an authoritative ophthalmologist on strabismus and amblyopia, pointed out that good medical equipment can well assist doctors in the diagnosis and treatment of strabismus, and good equipment is fully functional, with precise and advanced characteristics. Under good medical equipment and ultra-high resolution microscopes, doctors can reduce a lot of errors and avoid some unnecessary problems.

Therefore, good equipment is the beginning of a successful operation.

Tips: The younger the age of strabismus, the better the effect. Strabismus surgery is not only to correct the eye position and improve the appearance, but more importantly, to establish binocular vision function, and the timing of the surgery is preferably before the age of 7.