How much can medical insurance cover for hemorrhoid surgery

Hemorrhoidal surgery is covered by medical insurance and can be reimbursed for hospitalization with medical insurance.

For those who participate, the reimbursement process is as follows:

1) Participating farmers holding the "New Rural Cooperative Medical Certificate" in the outpatient clinic of the designated institution**, the designated medical institutions shall directly reduce or reduce the medical expenses according to the existing amount of the "New Rural Cooperative Medical Certificate" family outpatient account, and the excess part shall be paid by the participating farmers. Designated medical institutions should settle with agricultural medical institutions in a timely manner.

2) If the participating farmers are hospitalized in the designated medical institutions of the city, county or township, the designated medical institutions shall make direct supplements. The designated medical institutions shall review the medical expenses incurred by them, and pay the amount of subsidies in advance according to the standards stipulated in the implementation measures.

Participating farmers who are hospitalized in provincial-level designated medical institutions and non-designated medical institutions shall be compensated by township agricultural medical institutions. If the hospitalization medical expenses are less than 2,000 yuan (including 2,000 yuan) at one time, they will be reimbursed by the township (town) agricultural medical institute, and if they have doubts about the hospitalization information, they will be reimbursed only after being reviewed by the township (town) agricultural medical institute and submitted to the county agricultural medical bureau for review and approval.

1) When applying for compensation, it is necessary to bring the ID card, household registration booklet, the "New Rural Cooperative Medical System Certificate" (the original copies of the three certificates will be copied and stored at the bottom) of the medical institution, the discharge summary (or medical record), the list of expenses and the referral certificate.

2) Participating farmers suffering from outpatient serious diseases (chronic diseases) shall bring their ID cards, household registration books, "New Rural Cooperative Cooperative Certificates", outpatient invoices and lists, outpatient medical records, inspection reports, and outpatient serious diseases (chronic diseases) certificates of second-class hospitals or specialized hospitals to the township (town) agricultural medical office at the specified time (generally in July and December of each year).

3) For participating farmers who have participated in commercial insurance and students who have participated in student medical insurance, after being discharged from the hospital, they need to be compensated by commercial insurance and compensated by NCMS.

Participating farmers should first submit the original hospitalization invoice and a copy of the invoice to the agricultural medical institute or county-level designated medical institution for verification and then compensate, and then send the original hospitalization invoice to the commercial insurance company for compensation. Copies of invoices shall be kept by agricultural medical institutes or county-level designated medical institutions, but trauma patients can only be reimbursed in original copies (except for students).

4) The hospitalization expenses shall be settled within a limited time, and the compensation settlement procedures can be handled at any time within three months after discharge, and those who exceed three months shall be deemed to have given up the compensation by themselves (those who go out can be postponed to the end of the year). The amount of compensation to be paid by the agricultural medical institute according to the standard stipulated in the implementation measures shall be paid to the participating farmers within 10 working days.

Hemorrhoid surgery is covered by medical insurance, and it goes without saying that the reimbursement rate depends on the level of the hospital you are staying at.

Although hemorrhoid surgery is a minor operation, it is necessary to stay in the hospital, and you cannot get out of bed immediately after the surgery.

Hemorrhoidal surgery is covered by social medical insurance and can be reimbursed by medical insurance. Reimbursement ratio: 1. Outpatient and emergency medical expenses:

The cumulative medical expenses of in-service employees within the scope of basic medical insurance exceed 2,000 yuan in the year. 2. Settlement ratio: 50% of the part of the dispatched personnel more than 2,000 yuan during the contract period, and 50% of the personal payment;

Social security reimbursement for hemorrhoidal surgery is based on local conditions.

1. In-service employees, after going to the outpatient and emergency department of the hospital, can be reimbursed for medical expenses of more than 1,800 yuan, and the reimbursement ratio is 50%.

For retirees under the age of 1,300, expenses of more than 1,300 yuan can be reimbursed, and the reimbursement ratio is 70%.

For retirees over the age of 1,300, 80% of the expenses above 1,300 yuan can be reimbursed. The maximum amount of hospitalization expenses paid by basic medical insurance in a year is currently 70,000 yuan.

4. 95% of the expenses exceeding 40,000 yuan to the maximum payment limit can be reimbursed, and the employee only needs to pay 5%.

5. The proportion of personal payment of retirees is 60% of the above-mentioned employees, but those below the minimum payment standard are paid by individuals.

6. Hemodialysis, peritoneal dialysis.

Social insurance refers to a social and economic system that provides income or compensation to a population that is incapacitated, temporarily unemployed, or lost due to health reasons. The main items of social insurance include endowment insurance, medical insurance, unemployment insurance, work-related injury insurance, and maternity insurance.

The social insurance program is organized by **, forcing a certain group to use a part of its income as a social insurance tax (fee) to form social insurance**, and under the condition of meeting certain conditions, the insured can receive a fixed income or loss compensation from **, which is a redistribution system, and the goal is to ensure the reproduction of material and labor force and social stability.

[Legal basis].

Article 30 of the Social Insurance Law of the People's Republic of China 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 should 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.

Good medical insurance long-term medical treatment can reimburse the cost of hemorrhoids surgery, which belongs to the scope of general disease medical insurance, and the insured has hemorrhoids surgery in the hospital after the waiting period of 30 days, so the surgical expenses, drug fees, and outpatient expenses incurred before 7 days and 30 days after hospitalization are all within the scope of reimbursement. However, there is a deductible of 10,000 yuan for long-term medical care and general illness medical insurance, which is guaranteed to be shared during the renewal period, and the reimbursement ratio is 100%.

Hemorrhoids surgery costs can be reimbursed by medical insurance 50%-90%, under normal circumstances, the reimbursement ratio of resident medical insurance is 50%-60%, the reimbursement ratio of employee medical insurance is 70%-80%, and the reimbursement ratio of provincial medical insurance is more than 90%. The reimbursement ratio is directly related to the drugs and consumables used in hospitalization, and the drugs and consumables that belong to self-paid items cannot be reimbursed by social insurance.

[Legal basis].Article 28 of the Social Insurance Law of the People's Republic of China.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

Article 29 of the Social Insurance Law of the People's Republic of China.

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit. 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.