Plastic surgery hospitals generally cannot use medical insurance cards because plastic surgery is not covered by medical insurance reimbursement. However, if it is a plastic surgery hospital at the level of a third-class first-class hospital, it meets the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and this part of the expenses can be reimbursed. In short, medical insurance is mainly used to reimburse medical expenses of a therapeutic nature, not cosmetic and plastic surgery expenses.
Medical insurance coverage's restrictions:
1. Basic medical insurance policy: stipulate the basic coverage of medical insurance, which usually only includes necessary and therapeutic medical services;
2. Classification of medical services: medical services are divided into therapeutic and improvement (beauty), and medical insurance generally only covers therapeutic services;
3. Control of medical expenses: In order to control medical expenses, medical insurance usually excludes unnecessary medical services, such as cosmetic surgery;
4. Limitation of medical insurance catalogue: the scope of medical insurance payment is usually determined by the catalogue of medical insurance drugs and services, and the beauty department items are not in the catalogue;
5. Prevent resource abuse: limit the scope of medical insurance, prevent the abuse of medical resources, and ensure that basic medical needs are met.
To sum up, medical insurance generally cannot be used for cosmetic expenses, but part of the expenses of plastic surgery hospitals that meet the relevant standards can be reimbursed.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.