Can children be reimbursed if they are not hospitalized?

Children who are not hospitalized can be reimbursed.

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.

The proportion of medical insurance reimbursement is as follows:

1, outpatient and emergency medical expenses, the medical expenses of employees in the current year (1 October 1 day 1 February 3 1 day1day) that meet the basic requirements of medical insurance coverage totaled more than 2,000 yuan;

2. Settlement ratio: 50% of the part of the dispatched personnel exceeding 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan;

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate;

4. Outpatient medical treatment for three kinds of special diseases. For the outpatient medical treatment for the insured who suffers from malignant tumor radiotherapy and chemotherapy, renal dialysis and kidney transplantation, the secondary and tertiary hospitals designated by the insured shall fill in the Declaration and Approval Form for Special Diseases of Medical Insurance according to the Certificate of Disease Diagnosis, and report it to the district medical insurance center for examination and approval. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.

5. Hospitalization.

The handling process of children's medical insurance is as follows:

1. The guardian of the insured child goes to the social security agency where the household registration is located to receive the application materials for insurance;

2. The guardian of the insured child should fill in the relevant forms carefully and declare the insurance information online according to the insurance requirements, and prepare the required reference materials to declare to the social security agency where the household registration is located;

3. The social security agency accepts the insurance information, reviews the insurance information, enters the insurance information, establishes the social security collection account and collects the application fee in the bank through the computer system;

4. After the collection of children's medical insurance premiums is successful, the guardians of the insured children can apply to the social security agency for making children's medical insurance certificates, print the certificate-making list in the children's insurance collection window, pay the certificate-making fee and go through the certificate-making procedures in the social security certificate-making window;

5. Within 20 working days from the date of accepting the certificate-making procedures, the guardian of the insured children will go to the social security collection agency to receive the children's medical insurance certificate and issue it to the insured.

To sum up, medical insurance is an insurance to compensate medical expenses caused by diseases.

Legal basis:

Article 30 of People's Republic of China (PRC) Social Insurance Law

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

(a) shall be paid by the industrial injury insurance fund;

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

(three) shall be borne by public health;

(4) Go abroad for medical treatment.