Regulations on medical insurance reimbursement of IVF
IVF refers to a method of pregnancy and delivery through artificial assisted reproduction technology, which is implanted into the mother body after in vitro fertilization and culture. For many couples who are unable to conceive naturally, IVF technology is the last straw for them to realize their reproductive dreams. However, the medical cost of IVF is high, which brings a great burden to the family economy. Therefore, understanding the medical insurance reimbursement regulations of IVF can provide some financial support for these couples.
1. Reimbursement scope
According to China's medical insurance policy, the medical insurance reimbursement scope of IVF mainly includes the following aspects.
First, the medical expenses of IVF can be included in the reimbursement scope of medical insurance. These costs include in vitro fertilization, embryo culture and transplantation, hormone therapy, surgery costs, etc. However, the reimbursement proportion and limit of specific expense items vary from region to region and hospital to hospital.
Secondly, some additional examination and treatment expenses can also be applied for medical insurance reimbursement. For example, the cost of gene testing, chromosome abnormality screening, genetic counseling, etc. for both spouses. The reimbursement rate of these expenses may be low, so it is necessary to consult the hospital and medical insurance department in advance.
Finally, medical insurance can also be applied for reimbursement of treatment costs of some complications. For example, the treatment cost of complications such as ovarian hyperstimulation syndrome occurred in the process of IVF. This part of expenses generally requires doctors to issue relevant medical records and medical certificates.
2. Reimbursement conditions
The medical insurance reimbursement of IVF needs to meet certain conditions.
First of all, couples need to hold legal and valid medical insurance certificates. In China, medical insurance is divided into medical insurance for urban employees, medical insurance for urban residents, and new rural cooperative medical care. When applying for medical insurance reimbursement of test tube babies, the corresponding social insurance card or medical insurance certificate shall be provided.
Secondly, the medical insurance reimbursement of IVF needs to choose a regular hospital. Some qualified public hospitals and private hospitals can provide IVF services, but the reimbursement ratio and limit of different hospitals may be different. Therefore, it is recommended that couples consult the medical insurance department before choosing a hospital to understand the medical insurance reimbursement policy of the hospital.
Finally, the couple needs to apply for reimbursement within the time limit specified by the medical insurance. In general, the medical insurance department has stipulated the application period for IVF medical expense reimbursement, beyond which no medical insurance reimbursement can be obtained. Therefore, it is recommended that couples go through relevant reimbursement procedures in a timely manner after receiving IVF treatment.
3. Reimbursement process
The medical insurance reimbursement process of IVF generally includes the following steps.
First, couples need to consult the medical insurance department before reimbursement to understand the specific reimbursement policies and requirements. The medical insurance department will provide relevant reimbursement guidelines, including the list of required materials, application forms and reimbursement standards.
Secondly, the couple needs to carry relevant medical certificates and expense receipts to the medical insurance department for reimbursement procedures. Medical certificates generally include diagnosis certificates issued by doctors, operation records and medical records. The expense receipt shall include detailed expense details and payment vouchers.
Finally, the medical insurance department will review and reimburse according to relevant regulations. The audit cycle is generally long, and couples need to wait patiently. Once the reimbursement is approved, the medical insurance department will directly transfer the reimbursement amount to the personal medical insurance account, and couples can query the account balance on the medical insurance card.
4. Reimbursement limit
There are some restrictions on medical insurance reimbursement of IVF.
First of all, the reimbursement amount of medical insurance is generally limited. The ceiling amount varies in different regions and hospitals. Please consult the medical insurance department for details. Once the reimbursement amount exceeds the upper limit, the excess expenses cannot be reimbursed by medical insurance.
Secondly, the expense items involved in medical insurance reimbursement may be limited. Some expenses of assisted reproductive technology, such as sperm freezing and surrogacy, are not covered by medical insurance reimbursement. Before couples decide to conduct IVF treatment, they'd better communicate with the medical insurance department to find out whether relevant expenses can be included in the reimbursement scope.
Finally, medical insurance reimbursement does not mean that all expenses can be reimbursed. Couples still need to bear some of their own expenses, such as self funded drugs, extra hospital expenses, etc. Therefore, when choosing IVF treatment, couples need to know about the relevant costs in advance and be prepared financially.
Summary
The medical insurance reimbursement regulations for IVF mainly include reimbursement scope, reimbursement conditions, reimbursement process and reimbursement restrictions. Couples need to choose a regular hospital and apply for reimbursement within the time limit specified by the medical insurance. During the reimbursement process, relevant medical certificates and expense receipts need to be carried and reviewed by the medical insurance department. The reimbursement amount generally has a ceiling and does not include all expense items. Understanding these regulations can provide some financial support for couples and help them realize their IVF birth dreams.
