Question: How much can children's heart surgery be reimbursed by rural medical insurance.
1、 Cost: The cost of cardiac stent surgery in China is related to the number of stents that need to be placed. Generally, one stent is placed at a total cost of about 30000 yuan, and the total cost of two is more than 40000 yuan. If more than three stents are placed, cardiac bypass surgery is recommended. Different hospitals in different regions may be different. 2、 Insurance proportion: At present, domestic drug stents belong to the material cost, which is generally included in the medical insurance reimbursement scope at the rate of 50. There are also some self funded medical expenses, which are generally deducted from the minimum payment standard (about 1000 yuan) and balloon and stent fees (about 5000 yuan for balloons and 14000 yuan for stents). Other expenses are hospital surgery and medical expenses. According to the provisions of medical insurance, they are reported as 85~90. As for the number of supports that can be reimbursed, it is stipulated that "the maximum cumulative payment limit of medical expenses paid by the basic medical insurance pooling fund to employees and retirees in a year is about 4 times the average salary of employees in the city in the previous year. Expand the medical insurance reimbursement ratio: 1. Outpatient and emergency medical expenses: the part of the medical expenses of the in-service employees that meet the requirements of basic medical insurance within the year (January 1, December 31) and exceed 2000 yuan accumulatively. 2. Settlement proportion: 50 yuan will be reimbursed for the part of the dispatched personnel over 2000 yuan during the contract period, and 50 yuan will be paid by the individual; The maximum amount of outpatient and emergency reimbursement paid to dispatched personnel in a year is 20000 yuan. 3. The insured personnel shall properly keep the outpatient medical bills (including receipts for the part below the large amount, the bottom of the prescription, etc.) for medical expenses reimbursement in the designated hospital. 4. Outpatient medical treatment for three special diseases: when the insured person needs to take anti rejection drugs in the outpatient medical treatment for radiotherapy and chemotherapy of malignant tumor, kidney dialysis, and kidney transplantation, the secondary and tertiary designated hospitals where the insured person goes to see the doctor shall issue a "disease diagnosis certificate", fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report to the District Medical Insurance Center for approval and filing. Outpatient treatment and drug taking for these three special diseases are only limited to designated hospitals that have approved the treatment, and cannot be purchased at designated retail pharmacies. If the medical expenses incurred conform to the scope of outpatient special diseases, they shall be settled by referring to hospitalization. 5. Hospitalization. After 20 years of medical insurance payment, you can enjoy the medical insurance reimbursement after retirement. The reimbursement proportion of medical insurance varies from place to place. Please refer to local policies and regulations for details. Source Medical insurance
