Are chronic disease examination fees reimbursed?

In most cases, insured persons who have registered for chronic diseases can be reimbursed according to regulations for necessary examination fees for the registered chronic diseases that are included in the local medical insurance chronic disease catalog. The specific amount and types of coverage that can be reported vary greatly from place to place.

A while ago, I helped my uncle who suffers from high blood pressure organize the reimbursement documents and went through the relevant rules. The blood lipids, liver and kidney function, and homocysteine ​​that he regularly needs to check every month are all items directly linked to the prevention and control of hypertension complications. He can go through the chronic disease reimbursement channel every time, and the ratio is more than 20% higher than that of ordinary outpatient clinics, which can save a lot of money. Last month, after seeing high blood pressure, he ordered a lung CT scan to check for nodules. This has nothing to do with the management of high blood pressure, so he can only apply for the reimbursement quota of ordinary outpatient clinics, and cannot follow the chronic disease policy.

Of course, not everyone can apply smoothly. The last time I asked my uncle for help at the medical insurance window, I encountered a patient arguing with the staff, saying that his examination fee would not be reimbursed. The patient suffered from rheumatoid arthritis and needed to be tested for an emerging autoantibody. The local chronic disease reimbursement directory had not been updated to include this test, so he had to pay out of pocket. This is also a controversial point in the field of chronic disease examination reimbursement: There is currently no unified chronic disease examination reimbursement catalog across the country. Each coordinating district delimits the scope based on the affordability of the local medical insurance fund. In areas with good economic conditions, there are more than a dozen reimbursable examination items corresponding to hypertension alone. Some small counties may only have two or three items such as blood pressure measurement and routine ECG. It is inevitable that some patients feel that their necessary examinations cannot be reimbursed, and it is not humane enough.

Before you really go for a chronic disease-related examination, there is no need to look at the catalog and guess whether you can apply for it. Just take your chronic disease certificate to the staff at the hospital’s medical insurance window and ask a few questions. It only takes a minute or two, and you don’t have to worry about finding out that you can’t apply for it after paying the fee. If you need to have a check-up in another place, remember to register a chronic disease in another place with the medical insurance bureau of the insured place in advance. Most areas now support the direct settlement of chronic disease check-up fees in other places. You don’t have to advance money yourself and then go back to the insured place to submit materials for reimbursement, which is much more convenient.

There is another pitfall that is the easiest to step into. Many friends clearly meet the conditions for chronic disease registration, but they find it troublesome and never go through it. Even if you do all the necessary examinations corresponding to chronic diseases, you will not enjoy the high reimbursement policy for chronic diseases. You can only go through the general outpatient service. The difference is really big. Those who meet the conditions are best to take the time to go to the community or the medical insurance bureau to register. It is much more worry-free.