However, the following conditions must be met:

1, the patient must be diagnosed by a doctor, and provide the corresponding medical records and inspection reports and other supporting materials;

2, the operation must be carried out in the provisions of the medical institutions, and completed by doctors with corresponding qualifications;

3, surgery must comply with the provisions and standards of medical insurance, and must be included in the medical insurance directory.

The scope of medical insurance reimbursement includes:

1, medical expenses during rescue;

2. Medical expenses during hospitalization;

3, surgical materials and AIDS;

4. Bed fee: according to local medical insurance standards. Except those who need to be admitted to ICU due to acute craniocerebral injury and complex visceral injury, they should be transferred to the general ward immediately after they are out of danger;

5. Rehabilitation physiotherapy fee: according to local medical insurance standards. In principle, there are no more than three kinds, and rehabilitation physiotherapy outside the scope of medical insurance will not be compensated;

6, dressing change and rehabilitation function guidance training: according to local medical insurance standards combined with disease needs;

7. Ambulance fee: calculated according to the standard approved by local health department and price department;

8. Other expenses: expenses that are not compensated according to regulations will not be compensated;

9. Continuing medical expenses: In order to close the case in advance, the insured can pay the necessary continuing medical expenses for the injured in the future in advance. Only when the discharge certificate or diagnosis certificate clearly indicates that the competent doctor needs to continue treatment, or the internal fixator is removed after half a year or one year, or the follow-up treatment expenses are reviewed or recorded regularly, and the compensation payment voucher provided by the insurance record for the follow-up expenses can be reviewed. According to the needs of the disease, obviously beyond the needs of the disease, the audit fee for continuing medical treatment will not be compensated.

To sum up, the medical insurance policies and regulations in different regions may be different, and the specific reimbursement standards and requirements may also be different. It is recommended to consult the local medical insurance department or hospital for specific policies and reimbursement procedures.

Legal basis:

Article 30 of People's Republic of China (PRC) Social Insurance Law

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.