1, the general population can not be reimbursed for gastroscopy in outpatient department;
2. If there are examination indications during hospitalization, you can do gastroscopy and be reimbursed by medical insurance.
Medical insurance reimbursement conditions:
1, hospitalization expenses;
2. Medical expenses within 7 days before emergency observation and hospitalization;
3, in line with the provisions of the urban residents special disease outpatient medical expenses;
4. Other expenses that meet the requirements.
The part paid by the basic medical insurance fund shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. If an individual is employed across the overall planning area, his basic medical insurance relationship will be transferred accordingly, and the payment period will be calculated cumulatively.
The process of medical insurance reimbursement:
1. local medical insurance reimbursement: after seeing a doctor in a designated medical institution, people who meet the requirements for medical insurance reimbursement can directly use the medical insurance card to make reimbursement settlement in the settlement window of the medical institution;
2. Reimbursement of medical insurance in different places: if the insured person has difficulty in diagnosis or has no treatment means in medical institutions in this city, he can apply for hospitalization in different places, fill out the Application Form for Transfer to Different Places, report to the municipal medical insurance agency for examination and filing, and then transfer to different places for treatment; If the insured person needs hospitalization for sudden illness in different places, he can report to the municipal medical insurance center in time (usually within three days) after admission. The medical expenses for transfer and emergency treatment in different places also need to be paid in advance by the insured, and then reimbursed to the municipal medical insurance center after discharge. It is recommended to go through the reimbursement procedures within one month.
To sum up, medical insurance reimbursement for gastrointestinal diseases needs to be determined according to the situation.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
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.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.