Is surgery on a broken bone reimbursable? How much can medical insurance cover for fracture surgery?

Fracture. Medical insurance can be reimbursed, but the reimbursement ratio depends on the local situation. The reimbursement procedure is quite complicated, you need to see a doctor first, and let the medical insurance office provide relevant medical records after the illness is cured.

and proof of diagnosis, if the investigation meets the conditions for reimbursement, then the reimbursement will be granted.

If some consumables are needed during the operation, they may not be reimbursed, or the reimbursement ratio is relatively small. It is mainly subject to local reimbursement availability.

In general, the second surgery of the fracture can be reimbursed, except for some cases that need to be paid by a third party. NCMS in some areas.

The policy stipulates that the second surgery on the fracture must be one year after the first surgery before it can be reimbursed.

Some local policies are that patients who are not reimbursed for the first surgery on a fracture cannot be reimbursed for the second operation. In most places, for those who need to be hospitalized twice for the same disease**, as long as the interval between the two hospitalizations is more than 30 days, they can be reimbursed.

Generally speaking, as long as the fracture is caused under normal circumstances, not a car accident, a brawl, etc., the first operation is open reduction and internal fixation of the fracture, and the second operation is the removal of the internal fixation after the fracture has healed.

If the second operation is due to the failure of the first operation, or due to various reasons such as fracture malunion, fracture nonunion, delayed fracture healing, etc., the cost of re-doing internal fixation surgery for the second or third time should be handled according to the relevant local policies of the patient.

Legal analysis: In general, 70% of the surgery for fracture can be reimbursed, and if the operation cost is 30,000 yuan, it can be reimbursed about 21,000 yuan, but the price of each place, as well as the specific medical insurance regulations are different, if some consumables need to be used in the operation, the consumables may not be reimbursed, or the proportion of reimbursement is relatively small, and the specific situation shall be subject to the local area. Legal basis:

Social Insurance Law of the People's Republic of China Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be settled directly by the social insurance agency and the medical institutions and drug business units. The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits. Article 30 The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid out of work-related injury insurance**; (2) It shall be borne by a third party; (3) It shall be borne by public health; (4) Seeking medical treatment outside the country. Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

Fracture surgery can not be reimbursed, because it is an accident, not a disease, basically not within the scope of reimbursement, if you have accident insurance, and the cost exceeds a certain amount, you can be reimbursed according to a certain percentage, but this money will not be too much.

As long as no third party is involved, it can be reimbursed.

Legal analysis: about 70% of the fracture medical insurance can be reimbursed. Under normal circumstances, the outpatient clinic of rural cooperative medical insurance can be reimbursed a little, and if the hospitalization exceeds three days, the medical expenses exceed 1,000 yuan, and the reimbursement can be given according to 60%.

Only urban workers can be reported for medical hospitalization, but generally not for outpatient services. The limit for each examination and surgery fee is generally 50 per visit, and the limit for prescription drugs is usually 100. "Opinions on Determining the Scope and Payment Standards of Medical Service Facilities for Basic Medical Insurance for Urban Employees" Basic medical insurance medical service facilities refer to 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 and outpatient (emergency) observation bed fees.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 3: The social insurance system adheres to the principles of wide coverage, basic protection, multi-level, and sustainability, and the level of social insurance shall be commensurate with the level of economic and social development.

Broken bones are not covered by medical insurance. However, you can enjoy medical insurance-related reimbursement. If you can enjoy the relevant reimbursement, it is like this, to enjoy the relevant reimbursement of medical insurance, you must continue to purchase for half a year or more than a year to be supported.

For medical insurance reimbursement, you need to go to the local medical management center or the medical insurance settlement window of the designated medical institution for reimbursement. Reimbursement for medical insurance is pro-rata and generally fluctuates around 70%. The proportion and amount of reimbursement are related to their own examinations and medications, medical level and other factors.

It is best to seek medical treatment in the place of purchase, and it is not possible to seek medical treatment in other places, so it is necessary to obtain approval from the local medical management agency before seeking medical treatment.

Some medical insurance can only reimburse the related medical expenses incurred due to fractures within the scope of medical insurance, and if the insured incurs medical expenses outside the medical insurance, such as the use of imported steel plates, then it cannot be reimbursed by medical insurance; However, there are also some medical insurance plans that provide out-of-pocket medical coverage and can reimburse out-of-pocket medical expenses outside of medical insurance.

Fractures can be treated with their own medical insurance, as long as they follow the process of medical insurance, after the self-payment period, the cost of medical treatment can be reimbursed by medical insurance in accordance with relevant regulations.

Fractures caused by trauma can be reimbursed by medical insurance, but the reimbursement procedure is relatively complicated, you need to see a doctor first, and after the illness is cured, let the medical insurance office provide relevant medical records and diagnosis certificates and other materials, and investigate those who meet the reimbursement conditions before reimbursement. If some consumables need to be used during the procedure. Consumables may not be reimbursed, or the reimbursement ratio is relatively small.

Hello, in addition to the "threshold fee" for hospitalization, some instruments and drugs are not covered by medical insurance, so they cannot be reimbursed. The cost of orthopedic surgery is mostly the cost of instruments such as K-nails, hollow nails, artificial joints, polymer splints, etc., which are generally not reported for imports. Postoperative nutrition and analgesic sustained-release agents are also not reimbursed.

Therefore, the total cost of the operation is about 50% for individuals, and if the choice of instruments and drugs is not covered by medical insurance, the reimbursement is less, hoping to help you.

It should be reimbursable, but it also depends on the specific scope of reimbursement, if someone else causes your fracture is someone else who bears your medical expenses, it is not within the scope of reimbursement, if it is your own reason, you can be reimbursed.

Although the landlord has a fracture, he is not hospitalized, and the medical insurance will definitely not reimburse him.

If you have a fracture, you should need to be hospitalized. If you are hospitalized, if you have medical insurance, then of course you will go to medical insurance, which is a very normal phenomenon! If you don't get hospitalized, you can't.

No, because this is an accidental injury, medical insurance will not reimburse it.

Can broken bones be covered by Medicare? If you have a broken bone under Medicare, you can use Medicare to reimburse you, and that's fine.

Hospitalization can only be reimbursed by medical insurance, you have a broken arm, but you only saw a doctor in the outpatient clinic and did it, and you are not hospitalized and cannot be reimbursed.

Can broken bones be covered by Medicare? Of course, you can be reimbursed by medical insurance, but you have to go to a regular hospital.

Can broken bones be covered by Medicare? Look at how the fracture is, if you accidentally break it, you can be reimbursed by medical insurance, and if you fall in a car accident, you won't be reimbursed.

Can broken bones be covered by Medicare? If the fracture is covered by Medicare, yes.

Of course, the bone joints can be reimbursed by medical insurance, and medical insurance is to ensure your reimbursement in the medical process.

If the expenses incurred in the medical treatment of fractures are covered by medical insurance, they can be reimbursed by medical insurance.

Fractures, if not hit by someone else's car. He is handsome. It can be reimbursed with a health insurance card.

If you have purchased medical insurance, if you have a fracture and are hospitalized, you can definitely reimburse the medical insurance through formal channels.

Fractures do not need medical insurance, medical insurance only for the sick and not for the injury.

Can broken bones be covered by Medicare? If you are not hospitalized, then he will not be reimbursed by Medicare.

As long as you accidentally break it yourself, the ** medical insurance can be reimbursed if you do it in a regular hospital.

If it's in medical insurance or something like that, it's okay.

Hello, it is generally said that outpatient services are not reimbursed, but it depends on your local specific situation.

I feel like it's working well for me, but this one varies from person to person.