It mainly depends on the service nature of special needs clinics and the specific provisions of medical insurance policies.

first, the nature of special needs outpatient service

special needs outpatient service is a high-end medical service project set up by the hospital to meet the special needs of patients, which usually provides a more comfortable environment, shorter waiting time and more professional medical services. However, due to the special nature of its service, the charging standard is often higher than that of ordinary outpatient clinics, so whether it is included in the scope of medical insurance payment needs to be determined according to the medical insurance policy.

ii. medical insurance policy

according to China's medical insurance policy, basic medical insurance mainly covers basic medical services, aiming at ensuring the basic medical needs of the majority of insured persons. For high-end medical services such as special needs clinics, medical insurance policies usually have certain restrictions. Specifically, the scope of medical insurance payment is mainly determined according to the nature of medical services, charging standards and medical insurance catalogue.

in the medical insurance catalogue, there are clear provisions on the scope of payment for special needs clinics. Generally speaking, patients can enjoy medical insurance payment if the services provided by special needs clinics belong to the items in the medical insurance catalogue and the charging standards meet the medical insurance regulations. However, if the services provided by the special needs clinic are beyond the scope of the medical insurance catalogue or the charging standard is too high, then the medical insurance may not be paid.

in addition, there may be differences in medical insurance policies in different regions. Therefore, patients should know the local medical insurance policy in advance when choosing special needs outpatient service, so as to avoid unnecessary expenses.

Third, the patient pays at his own expense and medical insurance

For outpatient services with special needs, if medical insurance is not paid, the patient needs to bear all the expenses by himself. However, some hospitals or doctors may offer some concessions or discounts to reduce the financial burden of patients. Therefore, patients can consult with hospitals or doctors to understand the relevant preferential policies when choosing special needs outpatient services.

To sum up:

Whether special-needs clinics in hospitals can take medical insurance mainly depends on the service nature of special-needs clinics and the specific provisions of medical insurance policies. When choosing special outpatient service, patients should know the local medical insurance policy and the charging standard of the hospital in advance, so as to make reasonable decisions. At the same time, patients can also consult with hospitals or doctors to understand the relevant preferential policies to reduce the economic burden.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

stipulates:

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

Article 3 of the Social Insurance Law of the People's Republic of China

stipulates:

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Those that should be paid from the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) It shall be borne by public health;

(4) seeking medical treatment abroad.

the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.