The reimbursement rate of some expenses is 6%-8%, and there are certain differences in different regional policies. Detailed compensation standards for children's congenital heart disease treatment costs: 1. If the participating children suffer from congenital heart disease and are hospitalized in a designated treatment hospital for surgery or interventional therapy, the deductible line will no longer be set when compensating. 2. Children with atrial septal defect, ventricular septal defect, patent ductus arteriosus, pulmonary valve stenosis and tetralogy of Fallot will be compensated according to 7% of the charging standard; children with interventional or blocking treatment will be compensated according to 5% of the charging standard.

Legal basis

Article 28 of the Social Insurance Law of the People's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations. Article 29 of the Social Insurance Law of the People's Republic of China, the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, the medical institution and the pharmaceutical business unit. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

legal basis

article 28 of the full text of the social insurance law of the people's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.

article 29 of the full text of the social insurance law of the people's Republic of China, the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, the medical institution and the pharmaceutical trading unit. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.