Is IVF within the scope of medical insurance reimbursement?
IVF technology refers to the medical technology that helps couples achieve their reproductive aspirations through in vitro fertilization, embryo donation and other means. However, due to its high cost, many people are concerned about whether IVF technology is within the scope of medical insurance reimbursement. The following will be detailed from four aspects: medical insurance policy, IVF costs, medical insurance administrative restrictions and specific hospital practices.
Medical insurance policy
At present, there are differences in the reimbursement of IVF in China's medical insurance policies. According to the Guide to IVF Technical Services issued by the National Health Commission, there is no clear regulation on the medical insurance reimbursement policy for IVF in China. The specific medical insurance reimbursement needs to be determined according to the region and medical insurance policy.
Taking Beijing as an example, according to the Standards for IVF Surgery Expenses and Card Collection Expenses of Designated Medical Institutions for Maternity Insurance issued by the Beijing Medical Insurance Bureau, IVF surgery expenses can be reimbursed by participating in maternity insurance, but the reimbursement proportion is limited. In order to obtain medical insurance reimbursement, patients need to go to designated medical institutions in Beijing for treatment, and need to meet certain conditions and procedures.
In contrast, the medical insurance policies in some regions did not provide reimbursement for IVF. Therefore, whether IVF is within the scope of medical insurance reimbursement needs to be determined according to the local medical insurance policy.
IVF expenses
The cost of IVF technology is relatively high, mainly including IVF surgery costs, IVF pregnancy aid costs and drug costs. These expenses usually need to be borne by patients at their own expense, and the proportion of medical insurance reimbursement is low.
Taking a hospital in Beijing as an example, the cost of IVF surgery in this hospital is about 200000 yuan, and the cost of other auxiliary treatment and drugs is about 50000 yuan. According to the maternity insurance policy, the reimbursement ratio of medical insurance is 30%, that is, patients can get a maximum reimbursement amount of 250000 yuan.
The high cost of IVF makes it difficult for many patients to afford. In addition to the limited proportion of medical insurance reimbursement, many patients still need to bear most of the costs themselves.
Administrative restrictions on medical insurance
In addition to the different regional medical insurance policies, there are also medical insurance administrative restrictions that have an impact on IVF reimbursement.
The first is the age limit. According to Beijing's maternity insurance policy, only women under the age of 45 can apply for medical insurance reimbursement of IVF. Patients over the age limit cannot obtain medical insurance reimbursement.
The second is the limit of embryo number. According to the Guide to IVF Technical Services, each IVF operation can only transfer two embryos, and patients with more than two embryos cannot obtain medical insurance reimbursement.
The administrative restrictions on medical insurance make some patients unable to enjoy the treatment of medical insurance reimbursement, and need to bear a higher economic burden.
Specific hospital practice
Although the state has not made clear provisions on the medical insurance reimbursement of IVF, some specific hospitals have also formulated corresponding reimbursement policies according to the practice.
For example, the IVF department of a top three hospital in Beijing has set up a medical insurance pilot, so patients can participate in IVF surgery through medical insurance, and can obtain corresponding medical insurance reimbursement. The practice of these hospitals is a blessing for patients who want to use medical insurance reimbursement to reduce their financial burden.
However, not all hospitals can provide medical insurance reimbursement services. When selecting a IVF hospital, patients need to know the specific conditions of the hospital, including whether to provide medical insurance reimbursement services, reimbursement proportion and reimbursement conditions.
Summary
The situation of IVF within the scope of medical insurance reimbursement varies from region to region and medical insurance policy. The current medical insurance policy does not clearly stipulate whether IVF is within the scope of medical insurance reimbursement, and the cost of IVF is high, so the proportion of medical insurance reimbursement is limited. In addition, medical insurance administrative restrictions and specific hospital practices also have an impact on IVF reimbursement. Therefore, before choosing IVF hospitals, patients need to know the local medical insurance policies and reimbursement of specific hospitals, as well as whether their age and number of embryos meet the conditions for medical insurance reimbursement.
