If I spend 1,000 yuan on emergency treatment and hospitalization, can the medical insurance reimburs

Updated on society 2024-06-30
4 answers
  1. Anonymous users2024-02-12

    The medical expenses incurred by the insured in the death of an ineffective emergency rescue, the medical expenses incurred during the period of emergency observation and inpatient observation, and the medical expenses of the insured person's emergency ** approved diseases for outpatient specified diseases shall not be included in the scope of overall payment for general outpatient services.

    If the emergency expenses incurred by the insured in the designated institution of medical insurance are reviewed by the medical insurance management department of the designated medical institution, they will be included in the overall settlement of the general outpatient clinic and will be reimbursed. However, the emergency medical expenses incurred by the insured in the general outpatient co-ordination and designated medical institutions of non-medical insurance designated institutions shall not be paid by the pooling fund.

  2. Anonymous users2024-02-11

    If the medical insurance can reimburse the outpatient expenses, the reimbursement expenses of the medical insurance include three parts: outpatient, inpatient and serious illness. However, the proportion of outpatient reimbursement is less than that of the other two uses. Under normal circumstances, the reimbursement ratio of outpatient clinics is less than 50%, and the part of the overall payment is less, most of which are paid by the personal account funds of the insured or in cash.

    The reimbursement ratio for hospitalization and serious illness fluctuates around 70%-80%, and fluctuates slightly according to the length of the insured's continuous payment period, and the longer the payment period, the higher the reimbursement ratio and payment limit.

    If the insured person does not go to the designated medical institution for medical treatment, then whether it is outpatient expenses or other expenses, they must bear their own expenses and cannot be reimbursed.

  3. Anonymous users2024-02-10

    Yes. Medical insurance reimbursement ratio: 1. Outpatient and emergency medical expenses:

    The cumulative medical expenses of in-service employees within the scope of basic medical insurance exceed 2,000 yuan in the year. 2. Settlement ratio: 50% of the part of the dispatched personnel over 2,000 yuan during the contract period, 50% of the personal payment, and the maximum amount of reimbursement for outpatient and emergency treatment of dispatched personnel in a year is 20,000 yuan.

    3. The insured person should properly keep the outpatient medical documents (including receipts and prescriptions for the following parts) in the designated hospital as the medical expense reimbursement voucher.

    Legal basis: Social Insurance Law

    Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

    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.

  4. Anonymous users2024-02-09

    Summary. Yes. Medical insurance can reimburse the cost of the emergency department, and the cost can also be reimbursed if you are not hospitalized, as long as you have a bill that meets the requirements.

    If the social security payer organizes the emergency department expenses incurred in the designated hospital of the medical insurance, after the approval of the medical insurance management method unit of the designated hospital of the medical insurance, it will be included in the overall liquidation of the general outpatient department and the expenses will be reimbursed. However, the comprehensive fund shall not be paid for the medical expenses incurred by the emergency department of the designated hospital for the general outpatient co-ordination of the medical insurance organized by the social security payer to the general outpatient clinic organized by the non-medical insurance designated hospital.

    Yes. Medical insurance can be reimbursed for the emergency department, and the expenses can be reimbursed if you are not hospitalized, as long as you have a bill that meets the requirements. If the social security payer organizes the expenses of the emergency department in the medical insurance Minchang designated hospital, after being approved by the medical insurance management method unit of the medical insurance designated hospital, it will be included in the general outpatient co-ordination and liquidation, and the expenses will be reimbursed.

    However, the comprehensive fund shall not be paid for the medical expenses incurred by the social security payer in the emergency department caused by the general outpatient clinic organized by the non-medical insurance designated hospital to coordinate the medical insurance designated hospital.

    Yes. Medical insurance can be reimbursed for the emergency department, and the expenses can be reimbursed if you are not hospitalized, as long as you have a bill that meets the requirements. If the social security payer organizes the expenses of the emergency department in the medical insurance Minchang designated hospital, after being approved by the medical insurance management method unit of the medical insurance designated hospital, it will be included in the general outpatient co-ordination and liquidation, and the expenses will be reimbursed.

    However, the comprehensive fund shall not be paid for the medical expenses incurred by the social security payer in the emergency department caused by the general outpatient clinic organized by the non-medical insurance designated hospital to coordinate the medical insurance designated hospital.

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