Hello, my friend is going to have lumbar surgery in Shanghai Changzheng Hospital. I heard that the cost is about 1.2 million. The company has paid the social security card. I'd like to ask about this charge. ... If it is Shanghai social security, you can press the card to be hospitalized directly.

Non-Shanghai Social Security Bureau can only apply for referral after the consent of the insured place, otherwise it will not be reimbursed.

All your expenses

eliminate

Threshold fee

Self-funded medicine

Self-financing project

Self-funded service facilities

The first self-funded part of Class B drugs

The first self-funded part of Class B diagnosis and treatment

After the remaining amount, according to the local provisions of the hospital level corresponding proportion distribution.

I think a lot of things are only known after discharge, so I can't determine the reimbursement amount before discharge.

According to the experience, it is normal that the reimbursement ratio of general expenses is lower than the overall reimbursement ratio of medical insurance 10-20%, mainly for threshold fees and self-funded items.

If it is too low, the general reason is that there are too many self-funded items, mostly in different places for medical treatment or recuperation, and the medical insurance catalogues of the two places do not correspond. For example, this AB disease can be treated with two drugs. A is in the medical catalogue, and B is in the insurance catalogue. If drug A is used for treatment, it will not be reimbursed at the insured place. If the insured place and the medical treatment place are always the same, doctors will generally switch to drugs with similar catalogue effects to avoid drugs and articles at their own expense. That's about it. I hope it is clear.

According to experience, the proportion of reimbursement for medical treatment in different places in Beijing and Shanghai is generally low.