Can medical insurance in icu be reimbursed?

Medical insurance in ICU ward can be reimbursed.

The medical insurance reimbursement in ICU ward depends on whether the patient is insured and whether the treatment items meet the medical insurance reimbursement standards. Items in the medical insurance reimbursement catalogue, such as ECG monitoring fee, ventilator use fee, injection fee, medical treatment fee, etc. , can be paid by the medical insurance fund. However, medical insurance is usually not reimbursed for expenses such as imported drugs that are not included in the medical insurance reimbursement catalogue. The proportion of medical insurance reimbursement in ICU wards is generally around 40%. For expensive new drugs or imported drugs, medical insurance reimbursement may be less. If the patient's condition improves, he can be transferred to the general ward and enjoy a higher proportion of medical insurance reimbursement.

1, medical insurance reimbursement policy: different regions have different medical insurance policies, which usually include outpatient expenses, hospitalization expenses, medicine expenses, etc. ;

2. Reimbursement ratio: According to different types of medical insurance and diseases, the reimbursement ratio may be different;

3. Designated medical institutions: Only medical expenses in designated medical institutions with medical insurance can be reimbursed;

4. Drug List: Drug expenses in the medical insurance drug list can be reimbursed, and non-list drugs are usually not reimbursed;

5. Special materials and treatment: some special medical materials and treatment items may need to be approved separately before reimbursement;

6. deductible line and capping line: medical insurance usually has deductible line and capping line, and the expenses need to be between them to be reimbursed;

7. Self-funded part: Some medical services and medicines may require patients to pay their own expenses and are not included in the scope of medical insurance reimbursement.

To sum up, the medical insurance reimbursement in ICU ward depends on whether the patient's participation and treatment items meet the medical insurance standards. Usually, it covers basic medical expenses, but does not include some expensive drugs. The reimbursement rate is about 40%, and regional differences may lead to different reimbursement rates and scope. Patients need to consult the local social security bureau for details.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.