Medical insurance fund is an important part of the national medical security system, including basic medical insurance fund, maternity insurance fund and medical assistance fund. The basic medical insurance fund is the main body, which is used to provide basic medical insurance for the insured, covering a wide range, including basic medical insurance for employees, basic medical insurance for urban and rural residents, industrial injury insurance, maternity insurance and so on. The maternity insurance fund is an insurance fund that provides medical security and maternity allowance for the insured during the maternity period. Medical assistance fund is a fund set up by the government to provide medical assistance to special people with financial difficulties or qualified conditions.
The process of medical insurance reimbursement:
1, medical treatment: go to a hospital or clinic for medical treatment or treatment;
2. Payment: Pay the medical expenses that should be paid in the hospital or clinic;
3. Obtain a list of expenses: during the medical treatment, the hospital or clinic will provide a list of expenses, which lists the specific medical items and amount;
4. Fill in the reimbursement application form: hold the expense list and fill in the medical insurance reimbursement application form. You need to provide your own basic information, medical expenses list, medical insurance certificate and other related materials when filling in;
5. Submit materials: submit the completed reimbursement application form and related materials to the medical insurance agency, which can be submitted online or offline;
6. Review: The medical insurance agency will review the submitted application forms and materials. After the approval, the medical insurance agency will transfer the reimbursement funds into the personal bank account or give cash reimbursement.
To sum up, in the process of reimbursement of medical expenses, the insured should abide by the relevant regulations, such as not making false reports or reimbursing in disguise, so as to avoid unnecessary losses in violation of the relevant regulations.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
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.