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Can medical insurance be used in special needs wards?

No. Special-needs wards are special-needs services that do not fall within the scope of diagnosis and treatment items covered by medical insurance. The portion that is higher than the range of bed fees paid by medical insurance cannot be reimbursed, and the portion that is higher than the range of bed fees paid by medical insurance cannot be reimbursed. . At present, special medical services are limited to analgesic delivery, doula-style delivery, D family delivery, plastic surgery and special needs outpatient clinics. Non-profit medical institutions are not allowed to add special medical services without authorization.

The biggest difference between special needs outpatient clinics and general outpatient clinics is that you can choose which expert to treat. Unlike ordinary outpatient clinics, which randomly arrange interns to treat patients, special needs outpatient clinics generally have fewer patients and the pressure on doctors is relatively high. It's a bit smaller in general, and if you look carefully, the registration fee will be relatively high.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 30 The following medical expenses are not included in the payment scope of the basic medical insurance fund :

(1) Should be paid from the work-related injury insurance fund;

(2) Should be borne by a third party;

(3) Should be paid by Those who bear the public health burden;

(4) Those who seek medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first. After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party. Hospitalization expenses in special wards can be reimbursed if they are within the scope of diagnosis and treatment items, medical service facility standards, emergency care, rescue, etc.; if they exceed the reimbursement scope, the excess cannot be applied for reimbursement and must be paid by the parties themselves.

"Social Insurance Law of the People's Republic of China"

Article 26 The treatment standards for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be in accordance with the national Provisions are enforced.

Article 28: Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit. The social insurance administrative department and the health administrative department should establish a medical expense settlement system for medical treatment in other places to facilitate insured persons to enjoy basic medical insurance benefits.