With the advancement of medical technology and the improvement of people's living standards, medical insurance has become an indispensable part of our daily life. However, reimbursement by health insurance is not without boundaries, and some expenses are not reimbursed by health insurance. This article will go through a recent news article, ** which expenses are not reimbursed by health insurance, and analyze the reasons behind them.
Let's review the news. Recently, a citizen found that the medical expenses he spent were not fully reimbursed by the medical insurance. After investigation, it turned out that some of these expenses were not covered by medical insurance. The news sparked widespread attention and made people think about which expenses are not reimbursed by Medicare.
First of all, expenses that do not reach the threshold or exceed the reimbursement limit cannot be reimbursed. This means that not all medical expenses are fully reimbursed in Medicare. Only when the medical expenses reach a certain threshold will the medical insurance start to reimburse. At the same time, if the medical expenses exceed the reimbursement limit, the excess will not be reimbursed. This is to control the cost of medical insurance and ensure the sustainability of medical insurance.
Secondly, expenses that are not covered by the medical insurance list cannot be reimbursed. The medical insurance catalogue is the basis for medical insurance reimbursement, and only the drugs, diagnosis and treatment items and medical service facilities listed in the medical insurance catalogue can be reimbursed. Therefore, if the medical expenses involve drugs, diagnosis and treatment items or medical service facilities that are not covered by the medical insurance list, then these expenses cannot be reimbursed.
In addition, the cost of not receiving medical treatment at a designated medical insurance institution cannot be reimbursed. Medical insurance stipulates that insured persons can only be reimbursed if they are treated at designated institutions under medical insurance. If the insured person is treated at a non-designated institution, the medical expenses incurred will not be reimbursed. This is mainly to prevent the insured from choosing the institution at will, resulting in the waste of medical insurance costs.
Finally, the expenses incurred during the period when the medical insurance is out of payment will not be reimbursed. Medical insurance is paid continuously, and if the medical insurance is discontinued within a certain period of time, then the medical expenses incurred during this period will not be reimbursed. This reminds us to maintain continuous payment of medical insurance in our daily life to ensure that we can get medical insurance protection when we need it.
In summary, reimbursement for Medicare is not without boundaries, and certain expenses are not reimbursable. This is mainly to control the cost of medical insurance and ensure the sustainability of medical insurance. Therefore, when visiting a doctor, we should pay attention to the selection of medical insurance designated institutions, maintain continuous payment of medical insurance, and understand the scope of the medical insurance catalog, so as to make better use of medical insurance resources. At the same time, the society should also strengthen the supervision and reform of the medical insurance system to improve the level of protection and sustainability of medical insurance.