Current location - Plastic Surgery and Aesthetics Network - Plastic surgery and beauty - Can strabismus surgery be reimbursed by medical insurance?
Can strabismus surgery be reimbursed by medical insurance?
Medical insurance for strabismus surgery cannot be reimbursed.

Strabismus surgery is usually not covered by medical insurance, because it is not covered by medical insurance. Strabismus is mostly caused by amblyopia, which is a congenital disease, but some experts believe that strabismus surgery belongs to the category of medical cosmetic surgery, and medical cosmetic surgery is not included in the medical insurance reimbursement project. Medical insurance reimbursement usually covers medical expenses during rescue, medical expenses during hospitalization, surgical materials and AIDS, bed expenses, rehabilitation physiotherapy expenses, dressing change and rehabilitation function guidance training, ambulance expenses and other prescribed expenses. The expenses for continuing medical treatment can only be reimbursed if the discharge certificate or diagnosis certificate is recorded by the competent doctor and requires further treatment or regular review. Therefore, strabismus surgery is not covered by medical insurance reimbursement, and patients have to bear their own expenses.

Treatment of strabismus:

1, vision training: through specific vision training equipment and methods, improve patients' vision and visual function;

2, glasses correction: for some strabismus patients, wearing appropriate glasses can improve vision and reduce strabismus symptoms;

3, medication: use muscle relaxants or other drugs to help regulate eye muscle tension and relieve strabismus;

4. Covering therapy: improve vision and eye position by covering normal eyes and forcing strabismus eyes to work;

5, surgical treatment: adjust the position and tension of extraocular muscles through surgery to correct strabismus. It is usually suitable for cases where drugs and other non-surgical treatments are ineffective.

To sum up, strabismus surgery is not covered by medical insurance reimbursement because it is regarded as medical cosmetic surgery. Although strabismus mostly comes from congenital amblyopia, because the medical insurance policy usually only covers the necessary medical expenses such as emergency treatment and hospitalization, patients need strabismus surgery at their own expense, and only when they are discharged from hospital or have continued treatment or regular review recommended by the competent doctor in the diagnosis certificate can they get partial reimbursement.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 27

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Article 28

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.