Details of medical insurance reimbursement for hemodialysis

At present, there is no specific reimbursement system for hemodialysis medical insurance in China. However, consumers have participated in the basic medical insurance, and their expenses can be reimbursed according to the relevant proportion when hemodialysis is carried out. According to the Analysis Report on the Development Prospect and Investment Strategic Planning of Hemodialysis Industry in China from 2015 to 2020 issued by Prospective Industry Research Institute, there are currently more than 2 million patients with end-stage renal disease (ESRD) in China who need dialysis treatment. According to the statistics of the Ministry of Health, there are only about 290,000 registered dialysis patients in China, and the actual estimate is about 330,000, including about 300,000 hemodialysis patients. According to the charges of different hospitals in different regions, the average price of hemodialysis is in 430 yuan -550 yuan. In 450 yuan, dialysis is twice a week and perfusion is 1-2 times a month. If the patient has no medical insurance, the monthly treatment cost in public hospitals is about 4,340 yuan, and the annual cost is about 52,000 yuan. Because hemodialysis belongs to the category of "special diseases", its settlement period is 360 days, and outpatient service is also reimbursed according to the proportion of hospitalization. According to the rules of urban medical insurance, after the self-funded 1300 yuan deductible line, if dialysis is done in a tertiary hospital, it needs 1300 yuan-30,000 yuan, and the reimbursement rate is 85%; The reimbursement rate of 30,000-40,000 is 90%; The reimbursement rate of more than 40 thousand yuan is 95%. If it is a secondary hospital, the reimbursement rate of 1.3 million yuan to 30,000 yuan is 87%, the reimbursement rate of 30,000 yuan to 40,000 yuan is 92%, and the reimbursement rate of more than 40,000 yuan is 97%. According to this regulation, if a patient is treated in a tertiary hospital, the cost for each dialysis is 24 yuan, and in a secondary hospital, only 14.4 yuan is required for each dialysis.