First, the basic principles and scope of the medical insurance system
The medical insurance system is a social security system established by the state to protect citizens' basic medical rights and interests. Its core purpose is to reduce the economic burden of people in the process of treating diseases or injuries. Medical insurance usually includes treating diseases, buying medicines and providing medical services, which are directly related to health.
Second, the particularity of infertility problem
Infertility refers to the couple's failure to conceive after a certain period of time (usually one year) without taking any contraceptive measures. This mainly involves reproductive health issues, not disease treatment. Although infertility may be caused by physiological, psychological, environmental and other factors, its essence is not a disease that can be cured by drug treatment or surgery.
Three. Limitations and Exceptions of Medical Insurance System
The coverage of medical insurance system is usually limited, and not all medical expenses can be reimbursed. In particular, some non-disease medical expenses, such as cosmetic surgery and assisted reproductive technology, are often not included in the scope of medical insurance. This is because these services are more personal choices or special needs than basic medical needs.
Four. Other possible support measures
Although infertility cannot be reimbursed through medical insurance, the state and local governments may introduce other relevant policies or measures to give some support. For example, some regions may provide subsidies or preferential treatment for assisted reproductive technology to reduce the economic burden of patients. At the same time, social charities or foundations may also provide related assistance projects.
To sum up, infertility can not enjoy medical insurance reimbursement because it does not belong to the category of disease treatment covered by medical insurance system. The medical insurance system mainly focuses on the treatment of physical health problems, while infertility mainly involves reproductive health. However, the government and all walks of life may provide some support and help to infertile patients through other channels.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
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.
People's Republic of China (PRC) social insurance law
Article 30 provides that:
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(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.