Whether hospitalization medical insurance needs to be paid in advance before reimbursement generally depends on the situation:

1. Only when the medical insurance that can be paid in advance is stated in the insurance contract can you apply to the insurance company to pay in advance, and then submit relevant information to the insurance company for reimbursement after the insured is discharged from the hospital, but the money that the insurance company can reimburse is generally used to deduct the money that has been paid;

2. If the insurance contract does not say that it can be paid in advance, then the insured needs to pay the medical expenses first, and then submit the hospitalization summary, hospitalization medical expenses list and hospitalization medical expenses invoice to the insurance company for reimbursement after discharge.

The proportion of reimbursement for hospitalization medical insurance is as follows:

1. For medical expenses incurred in tertiary hospitals, 85% will be paid by the overall fund and 15% by employees, with the minimum payment of 3, yuan; More than 3 thousand yuan to 4 thousand yuan, the overall fund to pay 9%, workers pay 1%; For the part exceeding 4, yuan, the overall fund pays 95% and the employees pay 5%;

2. For medical expenses incurred in secondary hospitals, 87% will be paid by the overall fund and 13% will be paid by employees for the part with the minimum threshold of 3, yuan; More than 3 thousand yuan to 4 thousand yuan, the overall fund to pay 92%, workers pay 8%; For the part exceeding 4, yuan, the overall fund pays 97% and the employees pay 3%;

3. For medical expenses incurred in first-class hospitals and family beds, the minimum threshold is 3, yuan, 9% will be paid by the overall fund and 1% by employees; More than 3 thousand yuan to 4 thousand yuan, the overall fund to pay 95%, workers pay 5%; For the part exceeding 4, yuan, the overall fund will pay 97% and the employees will pay 3%.

legal basis: article 29 of the social insurance law of the people's Republic of China

the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units.

the social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.

Article 3

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

(1) Those that should be paid from the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) It shall be borne by public health;

(4) seeking medical treatment abroad.

the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.