Myopia surgery is not reimbursable by medical insurance.

1. Rural Medical Insurance Reimbursement

1. Outpatient Compensation:

(1) Village clinics and village central clinics will reimburse 60% for each visit. The prescription drug fee limit is 10 yuan, and the health center doctor's prescription drug fee limit for temporary rehydration is 50 yuan.

(2) The town health center reimburses 40% of the fees for each visit, with a limit of 50 yuan for examination fees and surgical fees, and a limit of 100 yuan for prescription drugs.

(3) 30% reimbursement for visits to secondary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

(4) 20% reimbursement for visits to tertiary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.

(5) There is a limit of 1 yuan per prescription attached to the traditional Chinese medicine invoice.

(6) The annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.

2. Hospitalization compensation

(1) Scope of reimbursement:

A. Medication expenses: auxiliary examinations: electrocardiogram, X-ray, film, The fee limit for various examinations such as laboratory tests, physical therapy, acupuncture, CT, MRI, etc. is 200 yuan; the operation fee (referring to the national standard, if it exceeds 1,000 yuan, it will be reimbursed at 1,000 yuan).

B. For elderly people over 60 years old who are hospitalized in Xingta Town Health Center, treatment and nursing fees will be compensated 10 yuan per day, with a limit of 200 yuan.

(2) Reimbursement ratio:

The town health center will reimburse 60%; the second-level hospital will reimburse 40%; the third-level hospital will reimburse 30%.

The following are not included in the reimbursement scope of rural cooperative medical insurance:

1. Self-seeking medical treatment (seeking medical treatment without a designated hospital or not applying for a referral form), self-purchased drugs, and publicly funded medical treatment are not allowed Reimbursed medicines and medical expenses that are not in compliance with family planning;

2. Outpatient treatment fees, house calls, hospitalization fees, meals, companionship fees, nutrition fees, and blood transfusion fees (except for those with family blood banks, (reimbursed according to relevant regulations), heating and cooling fees, ambulance fees, special care fees and other expenses;

3. Medical expenses for car accidents, fights, suicide, alcoholism, work-related accidents and medical accidents;

4. Orthopedics, plastic surgery, dentures, prostheses, organ transplants, surgical fees, consultation fees, etc.;

5. Within the scope of reimbursement, the portion beyond the limit.

2. Urban medical insurance reimbursement

The scope of urban medical insurance reimbursement refers to all urban employers, as follows:

1. Including enterprises (state-owned enterprises , collective enterprises, foreign-invested enterprises, private enterprises, etc.);

2. Agencies, public institutions, social groups, private non-enterprise units and their employees must participate in basic medical insurance;

< p>3. Some cities and towns stipulate that township enterprises and their employees, owners of urban individual economic organizations and their employees must gradually be included in the scope of basic medical insurance (the last one depends on different policies in each place) before they can enjoy medical reimbursement.

Urban medical reimbursement mainly refers to medical treatment, medication, hospitalization, surgery, etc. in the hospital. Medical expenses can be reimbursed through the medical insurance card in accordance with relevant regulations. Urban medical insurance is relatively specific, and the project scale and The coverage is large, but its compensation for major illnesses or accidents is limited. At this time, the author recommends that the insured can purchase a combination of commercial critical illness medical supplementary insurance and social security to reduce their economic losses.

Extended information:

Employee medical insurance reimbursement

1. Scope of diagnosis and treatment items that are not covered by basic insurance

(1) Services Item Category

1. Registration fee, out-of-hospital consultation fee, medical record cost, etc.;

2. Clinic fee, expedited examination and treatment fee (except emergency), roll call surgery surcharge, Special medical services such as high quality and low price, self-recruitment of special nurse fees, etc.

(2) Non-disease treatment items

1. Various beauty (life beauty, medical beauty) and bodybuilding projects as well as non-functional plastic surgery, orthopedic surgery, etc.;

2. Various weight loss, fattening and heightening programs;

3. Various health examinations;

4. Various preventive and health-care diagnosis and treatment programs; registration Fees, out-of-hospital consultation fees, medical record costs, etc.;

(3) Diagnostic and treatment equipment and medical materials

1. Application of positron emission tomography equipment, electron beam CT, ophthalmology accurate Large-scale medical equipment such as molecular laser therapy instruments are used for examination and treatment projects;

2. Rehabilitation equipment such as glasses, dentures, prosthetic eyes, prostheses, and hearing aids;

3. Various self-use health care , massage, examination rehabilitation and treatment equipment.

(4) Treatment Items

1. Organ sources or tissue sources for various organ transplants or tissue transplants;

2. Except for kidneys and heart valves , cornea, skin, blood vessels, bones, bone marrow transplants and other organ or tissue transplants;

3. Orthopedics for myopia;

4. Qigong therapy, music therapy, health care Nutritional therapy, magnetic therapy and other auxiliary treatment projects.

(5) Others

1. Various diagnosis and treatment items for infertility (pregnancy) and sexual dysfunction;

2. Various scientific research, Clinically verified diagnosis and treatment items;

Reference: Baidu Encyclopedia - Medical Insurance Reimbursement Scope