What can be reimbursed by the "three catalogues" medical insurance mainly depends on the medical insurance catalogue. The medical insurance catalogue includes the medical insurance drugs catalogue, the diagnosis and treatment items catalogue and the scope of medical service facilities catalogue, that is, the "three catalogues". Only the medical expenses in the "three catalogues" can be reimbursed. 3。 Qifubiaozhun and capped Qifubiaozhun refer to the Qifubiaozhun of medical insurance funds. The medical expenses incurred by the insured in the "three directories" of designated medical institutions shall be borne by himself first, and the part above Qifubiaozhun shall be reimbursed by the medical insurance fund according to the regulations and proportions. . . .
The medical insurance fund will not pay the medical expenses that are not in the "three catalogues" and are not in the "three catalogues". Such as: cosmetic surgery, health care drugs, birth control pills, etc. 2。 After a work-related injury is identified as a work-related injury, the medical insurance fund will not pay the medical expenses paid by the work-related injury insurance fund in social security. 3。 It should be borne by a third person. . .
The detailed list of medical insurance reimbursement is as follows: 1, general medical insurance. It mainly includes outpatient expenses, medical expenses and inspection expenses. 2. Hospitalization insurance. Mainly the daily hospitalization expenses, hospital equipment use expenses, operation expenses, medical expenses and so on. 3. Surgery insurance. Provide all expenses incurred due to the patient's need for necessary surgery. 4. Comprehensive medical insurance. Its cost range includes all expenses such as medical treatment, hospitalization and surgery. 5. Special disease insurance. Some special diseases often bring disastrous expenses to patients, which ordinary families can't bear. Such as cancer and heart disease. The major diseases that provide protection for the insured can be single diseases, such as malignant tumors, or even some cancers in malignant tumors.
I hope the above content can help you. If in doubt, please consult a professional lawyer.
Legal basis:
"Detailed Rules for the Implementation of People's Republic of China (PRC) Social Insurance Law" Article 8.
The medical expenses incurred by the insured in the agreed medical institutions that meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards shall be paid from the basic medical insurance fund in accordance with state regulations.