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Can the operation be reimbursed? Commercial insurance?
Can the operation be reimbursed by commercial insurance?

But Gui Shuang didn't see what surgery you asked. Let me help you interpret it from the perspective of medical insurance terms.

Judging from the millions of medical insurance that is the hottest and cheapest on the market at present, mid-range and high-end medical care are not included in this discussion.

Millions of medical care can help us reimburse hospitalization medical expenses, and can reimburse medical expenses inside and outside the social security scope, with an annual insurance amount of 6,543.8+0,000.

Usually, its reimbursement is divided into two parts.

The general medical insurance amount is 1 10,000, of which 1 10,000 is spent by itself, and the rest can be reimbursed after deducting social security reimbursement 1.000%.

The medical insurance coverage for major diseases is 1 10,000, which can be reimbursed above 0 yuan. Similarly, 1 0,000% can be reimbursed after social security reimbursement.

However, millions of medical care is not a panacea, and not all problems are managed in hospitals. Let's look at the exemption clause of million medical insurance, which means that the insurance company doesn't care about the hospitalization expenses in the following situations.

1. The insurer is not responsible for any medical expenses incurred by the insured due to any of the following circumstances, or any of the following circumstances/behaviors:

(1) Intentional behavior

1) Intentional behavior of the applicant or the insured;

2) Suicide, intentional self-injury, fighting, drunkenness, drug abuse, smoking or injecting drugs.

(2) Past diseases and diseases that have not been truthfully reported.

1) Congenital diseases (subject to the International Statistical Classification of Diseases and Related Health Problems (ICD- 10) promulgated by the World Health Organization);

2) The insurer's previous illness (see definition 12 438+09) and its complications before initial or intermittent insurance;

3) Diseases or symptoms that the insured has suffered before the initial insurance or intermittent insurance.

(3) Non-accident treatment

1) Plastic surgery, cosmetic surgery, sex-change surgery, orthopedic surgery, vision correction surgery, ametropia, dental treatment, dental restoration;

2) glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation devices and all over-the-counter medical devices (except those deemed necessary by doctors for treatment);

3) Medical expenses incurred due to prevention, rehabilitation, health care or non-disease treatment projects;

4) circumcision, foreskin peeling, balloon dilatation and treatment of sexual dysfunction;

(five) the expenses for the treatment and rehabilitation of mental illness, schizophrenia, mental illness and sexually transmitted diseases;

6) The insured receives experimental treatment, that is, medical treatment without scientific or medical approval;

7) Medical expenses incurred by the insured due to occupational diseases (see explanation12.20);

8) Various medical appraisals, including but not limited to medical accident appraisal, psychiatric appraisal, pregnant woman's fetal sex appraisal, injury appraisal, paternity appraisal and genetic appraisal.

(four) the cost of maternity-related treatment

1) Pregnancy (including ectopic pregnancy), prenatal and postpartum examination, delivery (including caesarean section);

2) Contraception, sterilization, treatment of infertility, artificial conception and abortion (including abortion and induced abortion caused by any reason).

(five) medical expenses that do not meet the requirements.

1) Drug expenses or medical expenses incurred outside the hospital, nourishing Chinese herbal medicines and various wine preparations brewed by them, and drug expenses prescribed by doctors for more than 30 days;

2) receiving treatment or receiving the following medical services in the following institutions: clinics, family beds, nursing institutions, special needs medical care, foreign guests medical care, cadre wards,

Joint ward, international medical center, VIP department, joint hospital;

3) treatment without the approval of the local authority, or drugs or drugs without the approval or approval of the local government;

4) Patients who do not meet the admission criteria, are in hospital or are in hospital, should be discharged and refuse to be discharged (all medical expenses incurred since the date of hospital discharge).

Two, the insured in the following period of medical expenses, the insurer is not responsible for the payment of insurance money:

1) Diseases or symptoms that occur within 30 days from the effective date of this supplementary clause (there is no 30-day renewal provision);

2) Diseases examined during the waiting period but diagnosed after the waiting period;

3) During the period when the insured suffers from AIDS or is infected with HIV (the above definition is subject to the definition of the World Health Organization).

If the above virus or its antibody is found in the blood sample of the insured, it is deemed that the patient has been infected with the virus);

4) The performance of the insured's various vehicles and the duration of the vehicle race.