What can be reported for hospitalization, and what can be reimbursed for hospitalization expenses

For example, within a year, the cumulative cost of multiple visits by patients reaches 1,500 yuan, and then you can directly enjoy the overall payment. It does not mean that you have to spend more than 1,500 yuan to be reimbursed every time you see a doctor.

2.If you receive general outpatient clinics at designated community health service centers and township health centers under medical insurance**, and you are using drugs of national essential drugs, then the medical expenses will be paid directly by the overall plan** in accordance with the prescribed proportion, and there is no starting line.

If you are a town resident.

1) Urban residents (excluding college students): Within a settlement year, insured residents seek medical treatment in the general outpatient clinic of the designated community health service center or township health center where the insurance is registered (only the medical expenses in the catalog of basic drugs and diagnosis and treatment items), the minimum payment standard for each visit is 10 yuan, and the overall payment ratio after the minimum payment standard is 50%, and the cumulative maximum payment limit for the whole year is 1,000 yuan (including the minimum payment standard and the part of personal burden).

2) College students: Within a settlement year, insured college students seek medical treatment in the general outpatient clinics of all designated medical institutions in the city, and the minimum payment standard for each visit is 10 yuan, and the overall payment ratio after the minimum payment standard is 50%, and the ceiling line is 2,000 yuan (including the minimum payment standard and the personal burden part).

Except for the non-reimbursable items other than the food expenses, over-standard bed fees, and the three catalogs, the rest of the drug, diagnosis and treatment, examination and other expenses can be reimbursed according to the prescribed proportion!

Legal analysis: In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, as well as emergency and rescue medical expenses, in accordance with national regulations from the basic medical insurance**. Therefore, after taking out medical insurance, the medicines, diagnosis and treatment items, and medical service facilities that meet the requirements can be reimbursed, such as inpatient bed fees and outpatient (emergency) observation bed fees.

Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid from work-related injury insurance**, (2) it should be borne by a third party, (3) it should be borne by public health, and (4) it should be paid for medical treatment abroad.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

1. All kinds of self-financed drugs that do not belong to publicly-funded medical reimbursement, special-shaped packaged drugs, and unapproved purchased drugs. 2. ** fee, house visit fee, food fee, special nutrition fee, hospital escort fee, special care fee, baby fee, incubator fee, maternal health fee, bottle fee, Chinese medicine decoction fee (including medicine introduction fee), heating fee, air conditioning fee, ** fee, electric stove fee; TV bills, refrigerator bills, etc. in the ward. 3. Medical consultation fees, medical insurance premiums (referring to the additional insurance premiums charged during the medical treatment period), high-quality and high-price (referring to special clinics opened by hospitals), and qigong fees (excluding qigong ** fees).

4. All kinds of physical examinations, preventive medications, vaccinations, infertility examinations and expenses organized by non-publicly-funded medical management departments. 5. All kinds of cosmetic, orthopedic, bodybuilding surgery, disposal, drugs and other expenses, as well as all expenses for the use of orthopedic and bodybuilding equipment. 6. Travel expenses for medical treatment, ambulance fees, consultation fees and consultation transportation expenses.

7. Medical expenses for various conferences. 8. Fees for various magnetic therapy supplies. 9. Medical expenses for self-diagnosis and treatment by a medical unit or physician without the introduction of a designated medical unit or the approval of a publicly-funded medical institution.

10. Medical expenses for recuperation, recuperation, or recuperation without the consent of the publicly-funded medical management institution. Ten.

1. All expenses incurred for disability caused by fighting, brawls, alcoholism, traffic accidents, medical accidents, etc. Ten.

2. Medical expenses incurred during family visits, investigations, further studies and lectures abroad. Ten.

3. Other expenses that should not be reimbursed in the public medical expenses as stipulated by the local public-funded medical management department.