Medical insurance, as a social security system, aims to solve the economic problems of people and reduce the financial burden of patients. In modern society, the cost of medical care is rising day by day, and the role of medical insurance is becoming more and more prominent. Through medical insurance, patients can enjoy a certain percentage of medical expenses reimbursed, thereby reducing financial pressure and increasing the motivation to seek medical treatment.
However, Medicare reimbursement is not unlimited. In practice, there are some restrictions on medical insurance reimbursement, known as "six non-reporting", including:
Medical expenses that are not covered and covered by insurance: Medical insurance has a clear coverage and catalog, and only medical expenses that meet the requirements are reimbursed. For out-of-catalogue expenses, medical insurance will not reimburse.
Medical expenses arising from illegal medical activities: Medical insurance aims to protect the legitimate rights and interests of patients, and medical insurance will not reimburse medical expenses arising from illegal medical activities, so as to maintain medical order and patients' rights and interests.
Increased medical expenses due to poor results: In the process, medical insurance will not reimburse medical expenses increased due to poor results. These costs are often associated with risk and difficulty, and patients need to consider carefully when choosing a plan.
Personal out-of-pocket items outside medical insurance: In the process of medical treatment, there are some personal out-of-pocket items, such as special wards, high-end medical equipment, etc. For such expenses, the medical insurance will not reimburse them, and the patient needs to bear them by himself.
Projects for which the insured has already enjoyed preferential policies: For projects for which the insured has enjoyed preferential policies, such as publicly-funded medical treatment, charitable assistance, etc., the medical insurance will not reimburse to avoid duplicate reimbursement.
Expenses incurred by the hospital in absorbing and retaining patients in the hospital: The medical insurance will not reimburse the expenses incurred by the hospital in absorbing and retaining the patients, such as transportation expenses and accommodation expenses.
Although there are certain limitations to medical insurance reimbursement, its importance cannot be overlooked. Medical insurance can not only reduce the financial burden of patients, but also improve the accessibility of medical services and promote the development of medical and health services. With Medicare, patients can seek medical care with greater confidence, improving their overall health.
The discontinuation of medical insurance payment will have a certain impact on individuals. First of all, during the period of medical insurance withdrawal, patients will not be able to enjoy medical insurance benefits, and if they need to seek medical treatment, they will need to bear all medical expenses by themselves. Secondly, the discontinuation of medical insurance payment will affect the continuous insurance period, which will affect the medical insurance treatment. Finally, the discontinuation of Medicare contributions can lead to greater financial pressure on patients when they need medical care.
In the face of the restrictions of medical insurance reimbursement, we should understand the "six non-reporting" in advance, so as to avoid unnecessary losses in the process of medical treatment. In practice, patients should carefully read the medical insurance policy, understand the reimbursement scope and limitations, and choose the appropriate plan according to their own situation. At the same time, patients can also further improve the level of medical security by purchasing commercial medical insurance.