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Can Xianjun Agricultural Medical Insurance reimburse the hospitalization of esophageal foreign bodies?
Hello,

Hospitalization caused by esophageal foreign bodies can be reimbursed as long as it is not intentional.

Reimbursement amount = (total cost-out-of-pocket amount-threshold fee) x reimbursement ratio

The specific reimbursement ratio is divided into the new rural cooperative medical system and urban employee social security:

1. Reimbursement ratio of urban and rural residents (new rural cooperative medical system): 90% in township hospitals, 87% in first-class hospitals, 80% in second-class hospitals and 65% in third-class hospitals.

2. Basic medical care for urban workers: the overall fund shall be paid according to the proportion of hospital grades: 85% for tertiary hospitals, 90% for secondary hospitals, 92% for primary hospitals, and 95% for community health service centers that have signed hospitalization service agreements with medical insurance agencies.

On this basis, the population over 50 years old will increase by 2%, over 60 years old by 4%, over 70 years old by 6%, over 80 years old by 8%, and over 90 years old by 10%. /kloc-the reimbursement rate for people over 0/00 years old is 100%.

The following circumstances are not included in the reimbursement scope of the new rural cooperative medical system:

(a) the outpatient medical expenses of designated hospitals in non-co-ordination areas (except for outpatient treatment expenses for special diseases), and the expenses incurred by failing to seek medical treatment according to regulations and purchasing medicines by themselves;

(two) the cost of family planning measures and medical expenses in violation of the family planning policy;

(three) dental implants, orthodontics, optometry glasses, hearing AIDS, artificial organs, beauty therapy, cosmetic surgery, rehabilitation (such as qigong, massage, physical therapy, magnetic therapy, etc.). ), as well as various accompanying expenses, medical transportation expenses, home visits and other miscellaneous expenses during hospitalization;

(4) If there is a third party's liability, the medical expenses incurred due to personal injury, such as traffic accidents, medical accidents and work-related injuries, shall be borne by the third responsible person according to law.

(five) medical expenses caused by illegal acts such as suicide, self-mutilation, taking poison, taking drugs, fighting and other intentional acts of their families;

(six) medical expenses incurred during going abroad or staying in Hong Kong, Macao and Taiwan;

(seven) drugs and articles that are not reimbursed according to the medical insurance system for urban workers;

(eight) other expenses determined by the District Medical Management Committee.