The provincial governments of Jiangxi, Shanghai, Qinghai, and Zhejiang have added assisted reproductive technology (ART) to their medical insurance payment systems, effective from June 1, 2024. This move follows the lead of Beijing, Guangxi, Gansu, Inner Mongolia, and Shandong, which have been covering ART under medical insurance since July 1, 2023.
In July 2022, the National Health Commission (NHC) and National Healthcare Security Administration (NHSA), along with 15 other ministries, issued a set of guiding opinions to gradually incorporate appropriate delivery analgesia and ART into the medical insurance funds payment system. The NHSA categorized the ART program into 12 items, providing a policy framework for regional governments to follow.
Pioneering regions like Beijing, Guangxi, Gansu, and Inner Mongolia have seen significant uptake, with 32,000 people seeking ART treatment in Beijing by the end of 2024, resulting in total spending of RMB 280 million, of which RMB 190 million was covered by medical insurance.
In Shanghai, there are 17 service items, 12 of which are included in the National Reimbursement Drug List (NRDL), with 5 classified as Category A items (eligible for 100% reimbursement). Insured personnel using Category A items will have their expenses paid in accordance with Shanghai’s basic medical insurance regulations. For Category B items, insured individuals must pay 10% of the costs out-of-pocket, with the remaining 90% covered by the national insurer.
Looking ahead, the NHSA plans to introduce a more unified national ART medical service list to further standardize the inclusion of related services under the NRDL.- Flcube.com
