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Reimbursement scope of urban and rural residents’ medical insurance

Mainly include medical expenses, drug expenses, examination expenses and some special treatment expenses.

1. Medical Expense Reimbursement

Medical expenses covered by urban and rural residents’ medical insurance include hospitalization expenses, outpatient expenses, and emergency room expenses. For hospitalization expenses, medical insurance can reimburse a series of expenses related to hospitalization such as bed fees, nursing fees, surgery fees, and treatment fees. For outpatient and emergency expenses, medical insurance can reimburse registration fees, diagnosis and treatment fees, examination fees, etc.

2. Reimbursement of drug expenses

Drug expenses included in the medical insurance catalog can also be reimbursed. The medical insurance catalog is formulated by relevant national departments and includes a variety of commonly used drugs and therapeutic drugs. When urban and rural residents purchase these drugs at medical institutions, they can enjoy the reimbursement policy of medical insurance.

3. Reimbursement of examination expenses

Medical insurance can also reimburse some examination expenses, such as X-ray, B-ultrasound, electrocardiogram and other routine examinations. These examination fees are an essential part of the diagnosis and treatment process, so medical insurance will reimburse them to a certain extent.

4. Reimbursement of Special Treatment Expenses

For some special treatments, such as dialysis, radiotherapy, chemotherapy, etc., medical insurance will also provide certain reimbursement. These treatments are often more expensive and pose a considerable burden to urban and rural residents. Therefore, the reimbursement policy of medical insurance can alleviate their financial pressure to a certain extent.

It should be noted that the specific scope and proportion of reimbursement may vary depending on regions and policies. Therefore, insured persons should learn more about local policies and regulations when enjoying medical insurance reimbursement.

In summary:

The reimbursement scope of urban and rural residents’ medical insurance covers many aspects such as medical expenses, drug expenses, examination expenses and some special treatment expenses. These reimbursement policies provide basic medical protection for urban and rural residents and help reduce their financial burden when facing diseases.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 28:

Compliance The basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

"Social Insurance Law of the People's Republic of China"

Article 30 stipulates:

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Should be paid from the work-related injury insurance fund;

(2) Should be borne by a third party;

(3) Should be paid by the company ***Health burden;

(4) Seeking medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first. After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.