Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency rescue costs shall be paid from the basic medical insurance fund in accordance with national regulations. The following medical expenses are not included in the scope of payment of the basic medical insurance fund: they shall be paid from the work-related injury insurance fund
It should be paid by a third party; it should be borne by the public health department, etc.
How to reimburse if the medical insurance card is not obtained? If the medical insurance card has not been received, individuals can also apply for reimbursement of medical expenses after being hospitalized. Individuals can submit relevant materials to their respective medical insurance centers for reimbursement.
Under normal circumstances, if an individual has not received a medical insurance card, he or she can go to the medical insurance center to get a temporary card specifically used for medical treatment to facilitate medical treatment.
Processing process: Bring all the information to the relevant departments of the local social security center to apply. After review, if the information is complete and meets the conditions, it can be processed immediately.
When the applicant applies for outpatient medical expense reimbursement, the amount transferred to the medical insurance personal account in the current social security year will be deducted first, and then the reimbursement amount will be determined.
Documents required for reimbursement: When applying for reimbursement, you must bring along the hospital's invoice, master list, doctor's order certificate, medical records and other materials.
You can go to see a doctor first, and then go to the medical insurance center for manual reimbursement. The reimbursement fees will be directly credited to the designated bank card.
Bring your valid documents (ID card, household registration book, etc.) to the nearby city, district or county medical insurance center or service point to complete the written loss report procedure. After the medical insurance staff confirms that the loss report operation is successful, the settlement of the card will be stopped within one hour.
When officially reporting the loss, you should go through the card replacement procedures and fill out the "Application Form" on the spot.
Legal basis: Article 28 and Article 30 of the "Social Insurance Law of the People's Republic of China" Individuals can submit relevant materials to their respective medical insurance centers for reimbursement.
Under normal circumstances, if an individual has not received a medical insurance card, he or she can go to the medical insurance center to get a temporary card specifically used for medical treatment to facilitate medical treatment.