The hospitalization list is the money spent during hospitalization, which is used for medical items, including treatment, nursing, medication, etc.
The actual medical expenses incurred are the expenses actually spent in the hospital.
How to understand the hospitalization expense list 1. Total amount: the total hospitalization expense, that is, all the expenses spent by the patient during the hospitalization.
2. Out-of-pocket expenses: expenses beyond the scope of the medical insurance catalog.
3. Out-of-pocket expenses for some items: For Category B items within the scope of the medical insurance catalog, the insured must first pay a proportion of the expenses out of pocket.
For example, Class B drug A costs 100 yuan, and based on a 5% out-of-pocket rate, there will be an out-of-pocket expense of 5 yuan for some items.
4. Deposit line: that is, the fee below the deductible standard. The Medical Insurance Bureau has set corresponding deductible standards according to different categories of insured persons and hospital levels.
Legal basis: Article 28 of the "Social Insurance Law of the People's Republic of China" that meets the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be deducted from the basic medical insurance fund in accordance with national regulations.
Pay.
Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.
The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.