Whether the plastic surgery center of Nantong Zhongshan Hospital can apply for reimbursement of medical insurance
Nantong Zhongshan Hospital is a comprehensive hospital in Nantong City. It has a plastic and beauty center, which provides various plastic and beauty services, including nose augmentation, breast augmentation, liposuction and other operations. When considering plastic surgery, many patients will be concerned about whether they can use medical insurance to reimburse the cost of surgery. The following details the medical insurance policy, qualification of Nantong Zhongshan Hospital, medical insurance reimbursement scope and operation process.
1、 Medical insurance policy
According to the provisions of the national medical insurance policy, the scope of reimbursement for plastic and cosmetic items by medical insurance is very limited at present. Most plastic and cosmetic items are considered as "cosmetic surgery" and are not included in the medical insurance reimbursement scope. Plastic surgery can be reimbursed by medical insurance only in the following cases:
1. Medical necessary plastic surgery such as malignant tumor, congenital malformation and postoperative malformation;
2. Repair surgery for facial injuries caused by accidents;
3. Deformity repair surgery caused by disease or trauma.
The vast majority of plastic and cosmetic items are "cosmetic surgery", which is not within the scope of medical insurance reimbursement. Therefore, most items of the plastic surgery center of Nantong Zhongshan Hospital cannot be reimbursed through medical insurance.
2、 Qualification of Nantong Zhongshan Hospital
Nantong Zhongshan Hospital is a formal comprehensive hospital with rich medical resources and professional medical team. The plastic surgery center is one of the important departments of the hospital, equipped with advanced equipment and technical force. The doctors in the center have rich experience in plastic surgery and can provide professional surgical services for patients.
Although the plastic surgery center of Nantong Zhongshan Hospital has strong technical force, it needs to be clear that the qualification and technology of the hospital obviously cannot determine whether the plastic surgery project can be reimbursed for medical insurance. The key is to see the provisions of the medical insurance policy.
3、 Medical insurance reimbursement scope
According to the medical insurance policy, plastic and cosmetic items can only be reimbursed by the medical insurance under the above circumstances. Before plastic surgery, patients should consult with doctors in detail to understand whether the surgery can be included in the medical insurance reimbursement scope. If the operation is within the scope of medical insurance reimbursement, the patient can apply for reimbursement to the medical insurance department with the relevant certificate and reimbursement documents issued by the hospital.
However, it needs to be reminded that even if the plastic and cosmetic items meet the reimbursement scope of the medical insurance policy, the proportion of medical insurance reimbursement is limited. Generally, the medical insurance only reimburses part of the expenses, and the remaining expenses need to be paid by the patient at his own expense.
4、 Operation process
If the patient wants to reimburse the surgery expenses of the plastic surgery center of Nantong Zhongshan Hospital through medical insurance, the following operation procedures should be followed:
1. Consult the doctor before the operation to determine whether the operation conforms to the reimbursement scope of the medical insurance policy;
2. On the day of operation, the patient shall submit the application for reimbursement of operation expenses and relevant supporting materials;
3. The hospital will provide relevant reimbursement documents and supporting materials, and patients can apply for reimbursement to the medical insurance department with this material;
4. The medical insurance department reviews the expenses of plastic and cosmetic surgery according to the provisions of the medical insurance policy, and determines the amount of reimbursement;
5. The medical insurance department directly transfers the reimbursement amount to the patient's medical insurance account through bank transfer.
Summary
Most of the items in the plastic surgery center of Nantong Zhongshan Hospital cannot be reimbursed through medical insurance. According to the medical insurance policy, only surgery that meets specific conditions can be included in the medical insurance reimbursement scope. Before plastic surgery, the patient should consult with the doctor to know whether the surgery meets the requirements of the medical insurance policy. Patients need to note that even if the surgery can be reimbursed, the medical insurance will only reimburse part of the expenses, and the remaining expenses need to be paid at their own expense. In the operation process, patients need to follow the prescribed steps, provide relevant supporting materials and reimbursement documents, and finally apply to the medical insurance department for reimbursement. To sum up, in most cases, the medical insurance cannot be reimbursed for the projects of the plastic surgery center of Nantong Zhongshan Hospital.
