Can I reimburse my wife s own medical insurance and hospitalization for fetal treatment?

For details, you can consult the local medical insurance department, and the policies vary from place to place.

The conditions for reimbursement are as follows:

1) Medical treatment at designated medical institutions for cooperative medical treatment;

b) Original invoices.

3) Medical insurance card and ID card.

Other Notes:

1) Scope of reimbursement: the general outpatient and emergency expenses incurred by the insured in the designated hospital or specialized hospital of medical insurance, traditional Chinese medicine hospital and Class A hospital selected by the insured.

2) Reimbursement ratio: The total amount of general outpatient emergency expenses incurred in a natural year exceeds 2,000 yuan, and 50% of the large medical mutual aid** of more than 2,000 yuan is paid, and 50% is paid by individuals. For retirees with a total of more than 1,300 yuan, the part of the excess of 1,300 yuan is covered by 70 years old, 70% of the large medical mutual aid** is paid by the individual, 30% is paid by the individual, and 80% is paid by the large medical mutual aid** over the age of 70, and 20% is paid by the individual.

The maximum payment limit in a calendar year is 20,000 yuan.

3) Medical management: general outpatient services, emergency expenses paid in cash, medical expenses incurred should be in line with the scope of the three major catalogs of medical insurance, when purchasing drugs, a special prescription should be issued in the designated hospital and stamped with a special seal for medical insurance purchase, and then to the designated pharmacy to purchase drugs.

4) Reimbursement process: If the minimum payment standard is exceeded in a natural year, the insured person will submit the documents to the unit or social security office, and the unit or social security office will enter the documents into the enterprise version, and declare the electronic information and documents to the medical insurance center. The medical insurance center will complete the review, settlement and payment within 15 working days.

5) Application materials: general outpatient and emergency receipts, medical insurance prescriptions (prescription double pricing), and detailed expenses of inspection.

6) Declaration date: 1-20 of each month, the current month's expenses should be declared the next month, and the current year's expenses should be declared before January 20 of the year.

If you don't reimburse, you must have a unit to pay. My wife resigned, and the people said that they would not be reimbursed for giving birth!

1. Can medical insurance reimburse the cost of hospitalization and fetal protection?

1. The hospitalization and fetal medical insurance cannot be reimbursed, and the expenses are reimbursed in the maternity insurance, and the medical service fees and drug expenses that exceed the provisions shall be borne by the employees. Maternity insurance is a social insurance system in which the state and society provide medical services, maternity allowance and maternity leave by the state and society when pregnant and pregnant women workers temporarily interrupt their work.

2. Legal basis: Article 6 of the Trial Measures for Maternity Insurance for Enterprise Employees.

The examination fees, midwifery fees, surgery fees, hospitalization fees and medicine expenses for female employees who give birth are paid by maternity insurance**. The medical service fees and drug expenses (including the drug expenses for self-financed drugs and nutritional drugs) in excess of the prescribed regulations shall be borne by the employees.

After a female employee is discharged from the hospital after giving birth, the medical expenses for diseases caused by childbirth shall be paid by maternity insurance**; Medical expenses for other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs to rest due to illness, it shall be handled in accordance with the provisions on sick leave and medical insurance benefits.

2. What is medical insurance?

Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by the risk of disease. Through the employer and individual payment, the establishment of medical insurance**, after the insured person is sick and incurs medical expenses, the medical insurance institution will give him a certain amount of economic compensation.

Can the newborn babies who did not come and buy social security be reimbursed for hospitalization?

Hello, whether the employee medical insurance can be reimbursed mainly depends on which kind of medical reimbursement is, if it is a comprehensive medical insurance, the cost of the employee during the fetal protection period can be reimbursed, and if the insurance is paid for hospitalization medical insurance, the employee must be hospitalized to be reimbursed. If the employee is insured and paid maternity insurance, the employee can only enjoy medical insurance reimbursement when he or she gives birth. Therefore, the employee's medical insurance may not be reimbursed, and it depends on what kind of medical insurance is paid.

In fact, the cost of fetal protection will not be too high, so even if the employee medical insurance can not be reimbursed, don't be too anxious, after all, as long as the fetus can be successfully protected, it is the most important thing to make the fetus develop and grow better. Therefore, regardless of whether the cost of fetal protection can be reimbursed or not, pregnant women should go to a large hospital for fetal protection, so that the fetal protection effect is good, and there is a uniform standard for fees.

Legal analysis: Hospitalization and fetal insurance can be reimbursed. After discharge, the inpatient department will issue a list of expenses after settling the accounts, and take this list to the medical insurance center together with the information copied in the ward.

As a result, soon after 3 working days, I received a notice from the medical insurance center, and after getting the list, I came to the inpatient department again to go through the settlement procedures, deduct the reimbursement from the original hospitalization deposit, and return it to the inpatient together with the balance of the hospitalization fee.

Legal basis: Article 29 of the Social Insurance Law of the People's Republic of China Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit. The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

1. The hospitalization medical insurance for fetal protection cannot be reimbursed, and the expenses are reimbursed in the maternity insurance, and the medical service fees and drug expenses that exceed the provisions shall be borne by the employees.

2. Legal basis: Social Insurance Law of the People's Republic of China

Article 28: In accordance 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 Article 55 of the state: maternity medical expenses include the following:

3) Other project expenses stipulated by laws and regulations.

For accidents in this regard, it is necessary to make different standards of compensation according to the subject of the injury, and if the hospital is unwilling to make truthful compensation, it is necessary to use legal means to protect its rights. Medical expenses: Calculated according to the medical expenses incurred by the personal injury caused by the medical accident to the patient**, paid by vouchers, but excluding the medical expenses of the original disease.

If it is really necessary to continue after the case is closed, it shall be paid according to the basic medical expenses.

Lost work expenses: If the patient has a fixed income, it shall be calculated according to the fixed income reduced by the patient due to lost work, and if the income is more than 3 times the average annual salary of the employee in the previous year in the place where the medical accident occurred, it shall be calculated according to 3 times

If there is no fixed income, it shall be calculated according to the average annual wage of the employee in the previous year in the place where the medical accident occurred. Hospitalization meal subsidy: Calculated according to the standard of business trip meal subsidy for general staff of the medical accident agency.

Escort fee: If the patient needs to be accompanied by a special person during hospitalization, it shall be calculated according to the average annual salary of the employee at the place where the medical accident occurred.

Disability living allowance: According to the level of disability, calculated according to the average annual living expenses of the residents in the place where the medical accident occurred, the maximum compensation is 30 years from the month of disability: however, if the person is over 60 years old, it shall not exceed 15 years

Those over 70 years old should not exceed 5 years. Expenses for disability appliances: If it is necessary to equip compensatory functional appliances due to disability, it shall be calculated according to the cost of universal appliances with the certificate of the medical institution.

Funeral expenses: calculated according to the funeral expenses subsidy standard stipulated by the place where the medical accident occurred.