What should be paid attention to in reimbursement of breast augmentation surgery?
Breast augmentation surgery is a cosmetic surgery to improve the shape and size of the chest by implanting a prosthesis or autologous fat. For many women, breast augmentation surgery can improve self-confidence, but the cost of surgery is high. Many people hope to get medical insurance or commercial insurance reimbursement. The following will elaborate on the matters needing attention in the reimbursement of breast augmentation surgery from four aspects: medical insurance policy, surgery selection, reimbursement materials and reimbursement process.
1、 Understand the medical insurance policy
Before deciding to perform breast augmentation surgery, you need to first understand the reimbursement scope and conditions of the medical insurance policy for the surgery. There are differences in medical insurance policies in different regions, which need to be judged according to the local policies. Generally speaking, medical insurance only reimburses some medical items. Breast augmentation surgery is usually classified as cosmetic surgery and is not included in medical insurance.
In addition, some places also have reimbursement under special circumstances. For example, patients with chest deformities due to genetic factors or diseases may be reimbursed by medical insurance. Therefore, it is very important to understand the local medical insurance policy before breast augmentation surgery.
2、 Select appropriate surgical method
There are many options for breast augmentation surgery, such as silicone implant, biomaterial implant and autologous fat implant. When selecting the operation mode, the possibility of reimbursement should be considered in addition to the aesthetic effect. Generally speaking, the operation cost of implanting silicone prosthesis is high, and some commercial insurance may reimburse it; Autologous fat implantation can achieve natural effects, so it can be regarded as reconstruction surgery and get medical insurance reimbursement in some places.
Therefore, when selecting the operation mode, we should refer to the medical insurance policy and commercial insurance terms to select the operation mode with reimbursement possibility.
3、 Prepare reimbursement materials
If you want to get reimbursement from medical insurance or commercial insurance, you need to prepare relevant reimbursement materials. In general, it includes the following:
1. Outpatient medical records: including the purpose and needs of surgery, doctors' diagnosis and suggestions, etc;
2. Operation contract: including details of operation costs and signatures of both parties;
3. Expense invoice: must include details. Some places require that the invoice must have the medical institution qualification of the invoicing unit;
4. Copies of medical insurance card and ID card;
5. Other materials that may be needed, such as the doctor's operation certificate and the hospital's authorization letter.
There may be some subtle differences according to different reimbursement objects. Therefore, when preparing reimbursement materials, you should consult relevant insurance companies or medical insurance institutions in a timely manner to understand the specific requirements.
4、 Follow the reimbursement process
After sorting out all the reimbursement materials, follow the reimbursement process. For medical insurance reimbursement, you can go to the local social security bureau or medical insurance center for consultation to understand the specific process of reimbursement application and the time and place of submission of materials.
If it is a commercial insurance reimbursement, you can consult the customer service of the insurance company or go to the local agency to handle the reimbursement procedures. Usually, it is necessary to fill in the reimbursement application form, provide relevant reimbursement materials, and provide payment vouchers for surgical expenses.
In a word, the reimbursement of breast augmentation surgery needs to pay attention to the medical insurance policy, select the appropriate surgical method, prepare the corresponding reimbursement materials, and operate according to the reimbursement process. Although the scope of reimbursement for breast augmentation surgery by medical insurance is limited, it can still provide certain financial support for patients when conditions are met.
Summary:
The following aspects should be paid attention to in the reimbursement of breast augmentation surgery: first, understand the medical insurance policy, and judge the reimbursement scope according to the local policy; Secondly, select the appropriate surgical method, refer to the medical insurance policy and commercial insurance terms, and select the method that has the possibility of reimbursement; Then prepare the reimbursement materials, including medical records, surgical contracts, invoices, etc; Finally, the reimbursement process should be followed, and the relevant procedures should be handled at the social security bureau or insurance company. Although the scope of reimbursement for breast augmentation surgery by medical insurance is limited, it can still provide certain financial support for patients when conditions are met.
