Can Millions Medical Insurance be reimbursed for congenital heart disease: Millions Medical Insurance does not reimburse for congenital heart disease, because congenital heart disease is not covered by Millions Medical Insurance, that is, the insured intentionally took out the insurance with the disease.

Medical insurance, so when an insured accident occurs, the insurance company will directly terminate the insurance contract, and naturally it cannot reimburse the insured for the medical expenses incurred by the treatment of congenital heart disease.

To put it simply, the health notice of Million Medical Insurance clearly asks whether the insured has congenital diseases, and people with congenital diseases, especially those with congenital heart disease, cannot successfully purchase Hundred Million Medical Insurance.

Thousands of medical insurance.

This also means that the policyholder did not truthfully inform the insurance company of the insured’s health status when purchasing the million-dollar medical insurance. According to the express provisions of the Insurance Law, if the policyholder deliberately fails to fulfill the obligation to truthfully inform the insured, the insurer will

If an insured accident occurs before the contract is terminated, the insured shall not be liable for compensation or payment of insurance premiums, nor shall the insurance premium be refunded.

As long as eligible participating (insurance) children are hospitalized in designated hospitals for the two diseases, they will enjoy compensation according to regulations. In principle, the reimbursement rate within the policy scope of the New Rural Cooperative Medical Insurance or Urban Resident Medical Insurance shall not be less than 70%.

Medical assistance for serious illnesses will have different reimbursement ratios when treated in hospitals of different levels.

The details are as follows: 1. If you are hospitalized in a first-level medical institution and the medical expenses are less than 400 yuan, there is no deductible; 2. If you are hospitalized in a second-level hospital, the proportion of medical subsidies can be increased to 75%.

~80%; 3. For treatment in tertiary hospitals, the proportion of medical subsidies can be increased to 55% to 60%; 4. For treatment at provincial tertiary hospitals, the proportion of medical subsidies can be increased to 55%.

Among them, the medical subsidy for outpatient coordination in townships and villages is as high as 65% and 75% respectively.

5. For 8 common serious diseases such as congenital heart disease in children, the new rural cooperative medical system’s subsidized disease quota is 70%. For 12 major diseases such as lung cancer, the new rural cooperative medical system’s subsidized disease quota will strive to reach 70%.

Legal basis: Article 30 of the "Social Insurance Law of the People's Republic of China" The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) should be paid from the work-related injury insurance fund; (2) should be paid by a third party

(3) Should be borne by the public health department; (4) Seek medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first.

After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.