Where to go for medical insurance card reimbursement

Where to go for reimbursement of medical insurance card expenses mainly depends on the specific medical situation and the type of medical insurance.

Generally speaking, if a participant receives treatment at a local designated hospital, he or she can usually be reimbursed directly at the hospital's health insurance settlement window. In this process, the participant only needs to present his or her health insurance card during the visit, and the hospital will automatically settle and reimburse the expenses through the health insurance system. After the reimbursement is completed, the participant only needs to pay for the actual incurred and unreimbursed medical expenses. For non-hospitalized cases, if the medical expenses are not automatically reimbursed, the participant needs to bring the hospital settlement invoice, diagnosis, expense details and social security card to the medical insurance window of the local government center or social security center for reimbursement processing. In case of treatment in other medical institutions, a referral certificate is also required. In addition, in the case of medicines purchased at a designated pharmacy, the insured person can also bring along his/her medical insurance card and ID card and make reimbursement at the pharmacy. The pharmacy staff will help reimburse the expenses to the health insurance system.

The use of medical insurance card should be noted:

1, prohibit cash

No unit, individual shall not violate the scope of use of medical insurance card and requirements, is strictly prohibited to cash.

2, some provinces and cities, medical insurance card can be used by the whole family

Part of the provinces and cities, such as the province of Zhejiang, Guangzhou City, medical insurance personal account balance funds over the years can be used to pay for the employee basic medical insurance participants spouse, children, parents and other close relatives of the medical insurance costs, to realize the family members of the **** help each other.

3, the following cases of medical insurance will not be paid

in the non-designated medical structure or non-designated retail pharmacies to purchase drugs (except emergency): due to their own fights and assaults, drug abuse or other illegal behavior caused by their own injuries: alcoholism, suicide, self-inflicted injuries and other reasons for medical treatment: due to traffic accidents, medical accidents, or other accidents caused by the responsibility of the injuries: as well as according to the national or local regulations should be paid by the individual.

To sum up, the reimbursement of medical insurance card can be made at hospitals, medical insurance designated pharmacies or local government center medical insurance window/social security center, depending on the medical situation and the type of medical insurance. For the case of medical treatment in a different place, you need to file a record with the medical insurance department first, and then go to the local medical insurance department for reimbursement. In either case, you need to prepare the relevant reimbursement documents and ensure the validity of your health insurance card and ID card.

Legal basis:

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

Article 12

Basic medical insurance premiums are collected on a monthly basis, and employers and practitioners shall pay the basic medical insurance premiums to the collection agency within the prescribed period. The part to be paid by the individual practitioner shall be withheld by the employer from his wages.