On February 21, 2022, the Beijing Municipal Medical Insurance Bureau, together with the Municipal Health Commission and the Municipal Human Resources and Social Security Bureau, issued the Notice on Regulating the Adjustment of Some Medical Service Price Items, which standardized the adjustment of 63 medical service price items, including 16 assisted reproductive technology items such as intrauterine insemination common in outpatient treatment.
The new policy will land on March 26, and the IVF fee can be reimbursed in a remarkable way. So, how does this policy define the reimbursement of IVF expenses? How much can it reimburse? And what are the benefits? Wait a minute.
I. Plate by Plate: How does this policy define medicare reimbursement for IVF surgery?
It is said that my colleagues and friends around me did not have such good welfare at that time, and it can be said that the state really spent a lot of effort to improve the fertility rate.
Before we made changes from education, now IVF can also be reimbursed. According to the content of Beijing Medical Insurance Fa [2022] No. 7, not only many items are unified in price, but also part of the treatment cost is included in the national medical insurance category A, Class A! Class A! Class A! The key content is said three times, we all know that Category A is the highest reimbursement rate in social security.
At present, Beijing is the first provincial-level unit in the country to incorporate assisted reproductive technology into medical insurance. In terms of reimbursement scope, 16 assisted reproductive technology projects involving a wide range of people, such as intrauterine insemination and embryo transfer, will be included in the scope of medical insurance Class A reimbursement.
Secondly, in terms of policy timing, this new policy will be implemented on March 26 and will be applied to public medical institutions in Beijing.
Finally, which hospitals can reimburse them?
As far as I know, throughout the IVF procedure, there are currently the following risks:
A, low success rate: young, good ovarian function of women, the success rate can reach 40-50%; and around 40 years old, the success rate can be reduced to less than 20%.
B, expensive: a IVF baby is about 20,000-30,000, some people have to do it several times to succeed, and medical insurance is not reimbursed.
C. Medical risks: for example, ovulation induction may lead to excessive ovarian stimulation, and even the occurrence of pectoral ascites, ovarian rupture, venous thrombosis, etc.; In addition, the probability of ectopic pregnancy such as ectopic pregnancy will also increase.
Therefore, doing IVF, whether it is for women's physical and mental health, or for the economic pressure on the family, is not a small test, if medical insurance can be reimbursed, it can really help many people.
However, many young ladies said that it is a bit regrettable that only surgery and laboratory projects can be reimbursed, and the cost of examinations and drugs cannot be reported, and it is said that the cost is indeed quite a lot. Although a little regret, but can be reported better than not reported, according to the general Class A outpatient more than 1800 non-community reimbursement ratio of 70%, you can probably calculate how much money to save.
Second, do the math: how much can we save after IVF surgery is included in medical insurance?
First of all, congratulations to my friends in Beijing, the financial pressure of doing IVF in the future has been greatly reduced. The cost of domestic artificial insemination is generally 5,000 yuan / cycle, while the cost of IVF technology is generally 25,000-40,000 yuan / cycle. If you may not succeed at one time and need to do it repeatedly, the cost will be higher. It is understood that more than half of patients need 2 or more treatments to succeed. Now with the backing of medical insurance, the cost of test tubes for ordinary people can be greatly reduced.
Currently, there are three types of IVF techniques, the first generation technique is embryo transfer (IVF-ET), the second generation technology is intraveal sperm microinjection (ICSI), and the third generation technology is preimplantation genetic diagnosis (PGD/PGS). Three types of technologies are suitable for different family situations, for example, three generations of technology are suitable for families with familial genetic diseases, and the price is also the most expensive.
Of the 16 assisted reproduction projects included in Beijing's medical insurance this time, two of which are IUI (artificial insemination), one is the second generation of IVF technology, and three are IVF third-generation technology. In terms of the cost of a single ordinary cycle, the average cost of a single cycle is 35,000-45,000 yuan (excluding three generations), and it is initially expected that medical insurance can cover 8,000-11,000 yuan, and according to the median calculation, the medical insurance reimbursement cost accounts for about 23% of the single cycle treatment cost.
According to this policy, the reimbursement items that can be used in test tubes are as follows:
generation:
Egg harvesting + sperm selection + IN VIF culture + embryo transfer
2400 + 750 + 1566 + 2300 = 7016×70% = 4911 yuan
Second-generation sac:
Vaginal puncture surgery + sperm treatment + single sperm injection + culture + blastocyst culture + freezing + transplantation
2400+750+3346+1566+1366+1266+2400=13094×70%=9165.8 yuan
Of course, the above are currently calculated by themselves, and the specific need to be implemented after the hospital settlement is based on yo. Anyway, the more projects you save, anyway, being reimbursed is a big plus, you say.
We all know that there is also a social insurance called maternity insurance, which can reimburse the cost of pregnancy to childbirth, in general, throughout the pregnancy to childbirth, we also have these 3 benefits: maternity allowance, maternity leave and reimbursement of expenses incurred during childbirth, which can really help a lot of people.
Dig a dig: IVF fees can be reimbursed, what benefits can it bring?
Recently, my wife's girlfriend she said that she had her own child through assisted reproductive technology, but she did not know how to tell her family, nor how to face colleagues and neighbors, etc. It is true that the treatment of infertility is far greater than that of medical treatment.
With the continuous advancement of the inclusion of IVF fees in the medical insurance policy, I also hope that one day, the "psychological counselors" who hang "emotional recovery" on all roads on the Internet can focus on patients and pay more attention to the clinical part.
After all, pregnancy is easy for some people, as easy as eating and drinking. It's hard for others to go up to the sky. There is no doubt that this policy still has a great effect on fertility, including the following:
1, directly beneficial to the current infertile population, that is, want to give birth but can not give birth.
According to statistics, the incidence of infertility in the mainland has been increasing in the past decade, climbing to 15%, and nearly 50 million people in the country have infertility problems, and the age of marriage and childbearing that continues to be postponed and the number of elderly pregnant women promoted by the two-child policy is increasing. Then, the inclusion of test tubes in medical insurance is the trend of the times, which may be a major good news for the assisted reproduction industry.
2, today's young people do not want to have children, may be because of no money, may be because of pressure. But when they are 35 or 40 years old, their income goes up, their savings are available, their houses are solved, and most of them will consider having children. But by then they may not be able to give birth, then assisted reproduction is just right.
3, finally, now that the reproductive age of young people is pushing back, the demand for assisted reproduction will also increase exponentially.
At the same time, after the implementation of the policy, the increase in industry penetration is expected to accelerate. From the supply side, the private hospital market accounted for only 10.71%. As demand increases, it will drive the expansion of the entire assisted reproduction market. While public hospitals have limited capacity, follow-up private hospitals are expected to usher in a window period and attract customers through value-added services. From the perspective of the industrial chain, the upstream of assisted reproduction, including medical machinery, may become a golden track.
Final words: now first in Beijing to implement, I believe that the follow-up will slowly begin to popularize the country, I only hope to be able to do it faster, because for people who do test tubes, the success rate of doing it a day earlier is a little higher.
It is foreseeable that the "how to give birth" countries have begun to pay attention; the "can not afford" countries have also begun to move (double reduction policy); the next should be a series of policies to stimulate the enthusiasm for fertility such as "all kinds of guarantees to be born and affordable", let us wait and see.