1, the cost of liver transplantation is within the scope of medical insurance reimbursement, but the specific reimbursement ratio should be subject to the local medical insurance policy; 2, postoperative anti-rejection drug outpatient expenses, the maximum payment limit of 5000 yuan in the first year, 4500 yuan in the second year, 4000 yuan in three years and later; 3. Persons who use anti-rejection immunomodulators after organ transplantation enjoy the national civil service Medicaid treatment; 4, organ transplant surgery should be submitted to the provincial medical insurance management center for approval and filing.
Basic principles of medical insurance:
1. Overall fund payment scope: the medical insurance fund is mainly used to pay the medical expenses incurred by the insured due to illness, including outpatient and inpatient medical services;
2. Rules for the use of personal accounts: personal account funds are mainly used to pay outpatient expenses, and some areas can also be used to pay medical expenses and hospitalization expenses;
3. Payment proportion and capping line: the proportion of medical insurance payment varies according to the level of medical institutions and different diagnosis and treatment projects, and there is an annual capping line limit;
4. Restrictions on designated medical institutions: Insured persons usually need to seek medical treatment in designated medical institutions in order to enjoy medical insurance reimbursement;
5. Restrictions on the list of drugs and items: the drugs and treatment items reimbursed by medical insurance should be in the list of medical insurance drugs and medical services.
To sum up, the amount of medical insurance reimbursement for liver transplantation is affected by the local medical insurance policy, and the reimbursement ratio of surgical expenses is different. There is an annual maximum payment limit for outpatient expenses of anti-rejection drugs after operation, and those who use anti-rejection immunomodulators after organ transplantation can enjoy the national civil service Medicaid, which needs to be approved and filed by the provincial medical insurance management center before operation.
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.