medical care at public expense refers to a social security system implemented by the state to protect national staff and provide free medical and preventive services to those who enjoy it through medical and health departments according to regulations.

The main difference between medical care at public expense and medical insurance is that the concept is different, and the coverage of people, the scope of protection, the subject of burden and the reimbursement ratio are different. For example, ordinary people are not qualified to enjoy medical care at public expense at all, and all medical care at public expense is aimed at national civil servants in essence, and the reimbursement ratio of medical care at public expense is higher than that of ordinary medical insurance.

hospitalization medical insurance reimbursement process and matters needing attention

1. When you are admitted or discharged, you must go to the medical insurance management window of each designated medical institution with a medical insurance IC card for registration. When in hospital, the individual pays the deposit of medical expenses in advance, and pays more and less after discharge. Medical expenses incurred before hospitalization registration are not included in the scope of payment of basic medical insurance. If the emergency hospitalization fails to go through the hospitalization registration formalities in time, it should go to the medical insurance management window to go through the hospitalization formalities on the day after admission with the emergency certificate (in case of holidays, it will be postponed), and the medical expenses that exceed the time limit will be borne by themselves.

2. deductible line of pooling funds for insured persons after hospitalization: the deductible line varies from place to place, which is generally 1% of the average annual salary of employees in the whole city in the previous year. In a basic medical insurance settlement year, the medical expenses for multiple hospitalizations are calculated cumulatively.

3. If the insured person needs to be referred or transferred due to illness, he/she shall put forward the opinions of referral (hospital) after being diagnosed by the deputy chief physician or department director of the designated medical institution above level 3, and the unit where he/she works shall fill in the application form, and go through the referral (hospital) formalities after being approved by the medical insurance management department of the designated medical institution.

The transfer is limited to provincial special hospitals, and the expenses are paid by me first, and the reimbursement standard should be 1% first, and then the reimbursable amount is calculated according to local regulations.

4. When the designated medical institutions leave the hospital, each designated medical institution will calculate the medical insurance reimbursement amount and the amount that the individual should pay, and the reimbursement amount will be settled by the designated medical institutions and the urban social insurance agencies, and the amount that the individual should pay will be settled by the designated medical institutions and the insured himself.

I hope the above contents can help you. If you have any other questions, please consult a professional lawyer.

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

Article 5 People's governments at or above the county level shall incorporate social insurance into their national economic and social development plans.

the state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance undertakings.

the state supports social insurance through preferential tax policies.

article 7 social insurance agencies shall regularly announce their participation in social insurance and the income, expenditure, balance and income of social insurance funds to the public.

article 72 social insurance agencies shall be established in the overall planning area. According to the needs of the work, social insurance agencies may set up branches and service outlets in this overall planning area with the approval of the local social insurance administrative department and organization management organ.

the personnel expenses of social insurance agencies and the basic operating expenses and management expenses incurred in handling social insurance shall be guaranteed by the finance at the same level in accordance with state regulations.

approved.