Congenital disability whose non-physiological function requires corrective treatment does not belong to the basic medical insurance coverage and cannot enjoy medical reimbursement, but belongs to the basic medical insurance coverage whose physiological function requires corrective treatment and can enjoy medical reimbursement. In-depth understanding of this requires consulting the Social Security Bureau.
However, according to the regulations of the new rural cooperative medical system, congenital polydactyly belongs to hand plastic surgery. If it affects the normal function of the hand, it is within the scope of reimbursement, but the operation should be carried out according to the specific implementation of the local new rural cooperative medical system.
legal ground
The scope of medical insurance reimbursement stipulates that the following items are not within the scope of medical insurance reimbursement:
(1) service items.
(1) Registration fee, out-of-hospital consultation fee, medical record fee, etc.
(2) Special medical services, such as visiting fees, expedited fees for examination and treatment, additional fees for roll-call surgery, high-quality and low-price fees, and self-invited intensive care.
(2) Non-disease treatment projects.
(1) all kinds of beauty and bodybuilding, as well as non-functional plastic surgery and orthopedic surgery;
(2) various weight loss, weight gain and height increase projects;
(3) various health checks;
(4) all kinds of preventive health care and diagnosis projects;
(5) all kinds of medical consultation and medical appraisal.
(3) Diagnostic equipment and medical materials.
(1) Examination and treatment items of large medical equipment such as positron emission tomography (PET), electron beam cT and ophthalmic excimer laser therapeutic instrument;
(2) glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation devices;
(3) all kinds of self-use health care, massage, examination and treatment equipment;
(4) The provincial price department stipulates that one-time medical treatment cannot be charged separately.
(4) Treatment items.
(1) The organ source or tissue source of various organ or tissue transplants;
(2) Transplantation of organs or tissues other than kidneys, heart valves, corneal skin, blood vessels, bones and bone marrow;
(3) Orthopedic surgery for myopia;
(4) Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) others.
(1) various infertility (pregnancy) and sexual dysfunction diagnosis and treatment projects;