Legal analysis: It can be reimbursed. As long as the cost of surgery is within the scope of medical insurance, it can be reimbursed according to the relevant proportion. 1. For active employees, only medical expenses of more than 1,800 yuan can be reimbursed after going to the hospital's outpatient clinic or emergency department, and the reimbursement rate is 50%. 2. Retirees under the age of 70 can be reimbursed for expenses exceeding 1,300 yuan, and the reimbursement rate is 70%. 3. For retirees over 70 years old, 80% of expenses above 1,300 yuan can be reimbursed. The maximum payment amount from the basic medical insurance pooling fund (hospitalization expenses) in one year is currently 70,000 yuan. 3. 95% of the expenses exceeding 40,000 yuan up to the maximum payment limit can be reimbursed, and employees only need to pay 5%. 4. The proportion of personal payment for retirees is 60% of that of active employees (as mentioned above), but anything below the minimum payment standard will be paid by the individual. 4. Hemodialysis and peritoneal dialysis.
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) They should be paid from work-related injuries paid from the insurance fund;
(2) Should be borne by a third party;
(3) Should be borne by the public health;
(4) Seeking 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.