Gynecological examination during hospitalization can be reimbursed; If it is done in an outpatient clinic, it is generally not reimbursed, but if there is a medical insurance card, it can be paid with the funds in the card. For the insured of cooperative medical care, after the outpatient expenses reach the deductible line, they can be reimbursed according to a certain proportion, but not in full. Gynecological examination fees in line with the basic medical insurance related directories and standards, medical insurance funds can pay the corresponding part, social insurance agencies and medical institutions can be directly settled. If the pregnancy examination expenses are within the scope of medical insurance reimbursement, they can be reimbursed by medical insurance; If it is within the scope of maternity insurance payment, such as the maternity check-up fee for female employees, it will be paid by the maternity insurance fund. Pre-pregnancy examination can also use medical insurance, but it can only be reimbursed by paying maternity insurance, and it must be carried out in designated medical institutions.

Basic principles of reimbursement scope of medical insurance:

1. Provisions on the scope of use of the medical insurance fund: The medical insurance fund is mainly used to pay the medical expenses of the insured for medical treatment due to illness;

2. Limitation of medical insurance payment scope: it usually includes outpatient expenses, hospitalization expenses and drug expenses. , but the specific scope and proportion of payment are determined by local medical insurance policies;

3. Items and medicines in the medical insurance catalogue: Only medicines and medical services listed in the medical insurance catalogue can be reimbursed by medical insurance;

4. Difference between individual account and overall account: individual account is mainly used to pay outpatient expenses, while overall account is mainly used to pay hospitalization expenses;

5. Regional differences: different regions have different medical insurance policies, and the proportion and scope of reimbursement may be different;

6. Special disease policy: For some special diseases, medical insurance may have special reimbursement policies, such as increasing the proportion of reimbursement or expanding the scope of reimbursement;

7. Restrictions on designated medical institutions: Insured persons usually need to seek medical treatment in designated medical institutions to use medical insurance reimbursement;

8. Annual payment limit: the insured person has a certain medical insurance payment limit every year, and the excess is paid at his own expense.

To sum up, gynecological examination fees can be paid by medical insurance, but they are generally not reimbursed when outpatient service is conducted, unless you have a medical insurance card, and the funds in the card are used to pay. After the outpatient expenses of the insured person of cooperative medical care reach the deductible line, they can be reimbursed in proportion. When the gynecological examination expenses meet the basic medical insurance catalogue and standards, the medical insurance fund can pay the corresponding part and settle directly with the medical institution. Pregnancy examination expenses within the scope of medical insurance reimbursement can be paid by medical insurance, and those within the scope of maternity insurance payment can be paid by maternity insurance fund. Pre-pregnancy examination can also use medical insurance, but maternity insurance must be paid and carried out in designated medical institutions.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

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