Emergency medical expenses can go to the medical insurance reimbursement

If a participant incurs emergency medical expenses at a designated medical insurance institution, he or she will be reimbursed after review by the medical insurance management department of the designated medical institution. The scope of reimbursement by medical insurance includes medicine, registration fee, out-of-hospital consultation fee, examination fee, surgery fee, hospitalization treatment fee and nursing fee.

Emergency medical insurance reimbursement conditions

Emergency medical care can be reimbursed by the medical insurance, but there are also specific conditions, generally specific conditions are as follows:

1, the insured person in the medical insurance clinics or hospitals designated for medical care, can not be in the non-medical insurance designated health care institutions;

2, emergency treatment items in the medical insurance reimbursement;

3, outpatient need to meet the starting point of the medical care;

This is a very good idea.

3. Outpatient treatment needs to reach the starting line to be reimbursed, taking Beijing as an example, the starting line for outpatient treatment is 1,800 yuan. （

4. Hospitalization expenses incurred for emergency rescue and hospital observation can also be reimbursed.

Generally, as long as we meet the above conditions, after the end of the hospital emergency treatment, discharge settlement can be real-time reimbursement of medical insurance.

Participants in the health insurance designated institutions in the emergency costs, the health insurance management department after review, into the general outpatient integrated settlement, can be reimbursed on an outpatient basis, if in the outpatient emergency after hospitalization, then outpatient emergency costs can be reimbursed after hospitalization together settlement.

Participants in the emergency treatment, you can directly use the social security card for settlement, in the health insurance of the health insurance settlement window will be calculated by the patient's personal commitment to the medical costs, the patient only need to pay personal commitment to the medical costs can be, for the reimbursement of part of the medical costs, the hospital will be directly with the health insurance agency settlement. If a participant does not settle the bill through the social security card after an emergency treatment, then he or she can bring his or her valid ID, social security card, outpatient medical records, original invoices and other information to the local health insurance bureau to apply for reimbursement in accordance with the process.

The outpatient medical insurance can be reimbursed, but the outpatient reimbursement is also a starting line requirements, only the medical expenses incurred by the reimbursement of more than the starting line, more than the part of the medical insurance reimbursement insurance, if not reach the starting line, then can not be reimbursed. The specific reimbursement rate is also subject to local regulations.

Legal basis

The People's Republic of China*** and the State Social Insurance Law

Article 28 The medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities as well as those of the emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with the state regulations.

Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.