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What are the reimbursement scope of medical insurance?
According to the provisions of the Social Insurance Law, as long as it meets the standards of the basic medical insurance drug list, first aid and rescue medical expenses, diagnosis and treatment items and medical service facilities, it can be paid from the basic medical insurance fund in accordance with state regulations. Among them, the reimbursement scope of social medical insurance mainly includes the following points:

1, drug reimbursement for basic medical insurance

Class A and B drugs included in the basic medical insurance coverage can be reimbursed.

2, the basic medical insurance treatment project reimbursement

The scope of basic medical insurance payment items must be determined in accordance with the scope of basic medical insurance diagnosis and treatment items stipulated by the state. The diagnosis and treatment items that are part of the expenses paid by the basic medical insurance can be paid by the insured in advance and then paid in accordance with the provisions of the basic medical insurance.

3. Reimbursement of basic medical service facilities

The reimbursement scope of medical service facilities of basic medical insurance covers the service facilities that the insured person must live in during the process of diagnosis and treatment, including bed fees for outpatient and emergency observation and bed fees for hospitalization. For some referral transportation expenses, emergency transportation expenses, infant incubator expenses, food incubator expenses, nursing expenses and escort expenses, the basic medical insurance fund cannot reimburse them.

Social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope: (1) should be paid by the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be borne by public health; (4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

skill

The above answer is only for the current information combined with my understanding of the law, please refer carefully!

If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.