1. The medical insurance fund only pays the physical and rehabilitation expenses of the insured for "central nervous system diseases and injuries" within six months after onset; For physical and rehabilitation treatment caused by other diseases, the medical insurance fund only pays for physical and rehabilitation treatment within three months after onset. If the insured carries out physical and rehabilitation treatment after the operation, the above period shall be counted from the beginning of the operation;
2. The concept of "location" as the measurement unit of physical and rehabilitation treatment items in this notice is: the limbs are divided into shoulders, elbows, wrists, hips, knees and ankles; The trunk is divided into four parts: neck, chest, waist and sacrum. The head is a part;
3, because of cerebral palsy rehabilitation treatment, the rehabilitation medical expenses in line with the basic medical insurance payment scope, the basic medical insurance fund to pay no more than 6 months of the year before the age of 3; After the age of 3, the annual payment shall not exceed 3 months.
Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue medical expenses standards, and shall be paid from the basic medical insurance fund in accordance with state regulations.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
Thirty-first social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.
Medical institutions shall provide reasonable and necessary medical services for the insured.