I. Classification of Plastic Surgery
There are many kinds of plastic surgery, including but not limited to repairing deformities caused by diseases or accidents and improving the beauty of the face or body. According to the nature and purpose of surgery, plastic surgery can be roughly divided into two categories: one is repair and reconstruction surgery, such as burn repair and deformity correction; The other is cosmetic surgery, such as double eyelid surgery, rhinoplasty and breast augmentation.
Second, the medical insurance policy
Medical insurance policies are usually formulated by local governments and will be adjusted according to local economic and social conditions. Generally speaking, the medical insurance policy will clearly list which medical expenses can be reimbursed and which can't. In most cases, plastic surgery due to illness or accident can be partially or completely included in the scope of medical insurance reimbursement. Cosmetic plastic surgery, because of its unnecessary nature, is often not covered by medical insurance reimbursement.
Third, the medical insurance reimbursement process
If plastic surgery meets the conditions of medical insurance reimbursement, patients need to consult the medical insurance department before operation and go through relevant procedures. After the operation, patients need to provide complete medical expense invoices and medical records, and apply for reimbursement according to the requirements of the medical insurance department. The medical insurance department will review the application and give corresponding reimbursement according to the policy.
Fourth, matters needing attention
When choosing plastic surgery, patients should fully understand the risks and effects of surgery and the possible medical expenses. If the operation is not covered by medical insurance reimbursement, the patient needs to bear all or part of the expenses by himself. In addition, patients should also choose regular medical institutions and plastic surgeons with professional qualifications for surgery to ensure the safety and effectiveness of the operation.
To sum up:
Whether plastic medical insurance can be reimbursed mainly depends on the type of operation and local medical insurance policy. Plastic surgery for repair and reconstruction may be partially or completely included in the scope of medical insurance reimbursement, while cosmetic plastic surgery is often not included in the scope of reimbursement. When choosing plastic surgery, patients should fully understand the relevant provisions of surgery and medical insurance policies to ensure that their rights and interests are protected.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
People's Republic of China (PRC) social insurance law
Article 30 provides that:
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.