The Hunan Healthcare Security Administration has issued a notification to include specific assisted reproductive medical services within the payment scope of Basic Medical Insurance (BMI) and Work Injury Insurance Funds, effective from October 1, 2024, for a period of five years.
Under this policy, a total of eight items, including artificial insemination, sperm retrieval, and oocyte retrieval, are covered by the provincial fund. Artificial insemination is classified under Category A management, meaning it is fully covered by insurance, while the other six fall under Category B, requiring a 10% co-payment from the patient. These services are subject to a single-line payment policy and are limited to designated medical institutions specializing in assisted reproduction. They are not included in the outpatient pooling limit but count towards the annual fund maximum payment limit for insured individuals. Within the scope of assisted reproductive services, there is no deductible, and the BMI pooling fund will cover 70% of the employee medical insurance payment and 50% of the urban and rural resident medical insurance payment. If the annual limit of the pooling fund is exceeded, the major illness insurance fund will pay according to the aforementioned ratios and will not be subject to medical assistance.
Any additional compliant outpatient or inpatient expenses during the treatment period will be processed in accordance with BMI outpatient or inpatient policies. The unified treatment policy will also apply to interprovincial settlements. There is no distinction between Category A and Category B services when enjoying work-related injury insurance benefits, and no restricted payment is implemented. The remuneration standards for these assisted reproductive services will be adjusted over time based on factors such as fund operations and the level of fundraising.
Previously, 19 provinces including Beijing, Guangxi, Inner Mongolia, Gansu, and the Xinjiang Production and Construction Corps had introduced similar policies to integrate assisted reproductive services into their insurance coverage.- Flcube.com
