1, the medical expenses paid by the insured in line with the basic medical insurance drug list;
2, in line with the medical expenses of the diagnosis and treatment project;
3. Medical expenses that meet the standards of medical service facilities;
4. Medical expenses for first aid and rescue.
Medical insurance reimbursement usually requires the following materials:
1. Medical expense invoice: Detailed expense invoice issued by medical institutions is required, including medical expenses, inspection fees, medicine fees, etc. The invoice shall include the name, address, telephone number, name and ID number of the medical institution;
2. Detailed list of medical expenses: Some medical insurance institutions may require a detailed list of medical expenses, including specific medical items, drug names, quantities, prices, etc.
3. Personal identification: valid personal identification, such as ID card and medical insurance card, is required;
4. Medical insurance card: Medical insurance institutions need a valid medical insurance card to inquire about medical insurance information;
5. Medical records: In some cases, medical insurance institutions may require medical records or doctors' diagnosis certificates to verify medical needs and expenses;
6. Other materials: According to the specific medical insurance system and policies, it may be necessary to provide other materials, such as special disease certificates, hospitalization certificates, operation records, etc.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.