Can I apply for medical insurance if I have an accident?

After a traffic accident, it is generally treated as a motor vehicle traffic accident, so it is difficult to reimburse the perpetrators in medical insurance. However, there are two situations in which medical insurance can be used to reimburse some medical expenses:

1, bear part of the responsibility in traffic accidents, and the medical expenses that bear the responsibility can be reimbursed in medical insurance;

2. Medical expenses shall be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party;

3. I am fully responsible for the traffic accident, and the medical expenses caused by my fault are not included in the payment scope of the basic medical insurance fund, and the medical insurance department must reimburse it. Medical insurance is an important part of social insurance. When an employee is sick, the cost of treating the disease can be reimbursed by medical insurance, which can reduce the economic responsibility of the employee for treating the disease.

The medical insurance reimbursement process contains the following information:

1, original ID card or social security card;

2. Original disease diagnosis certificate issued by tertiary or secondary hospitals of designated medical institutions;

3, outpatient medical records, inspection, test results report and other original medical information;

4. Original receipt of outpatient charges of medical institutions with unified finance and taxation;

5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;

6. Designated pharmacies: unified original invoices and computer-printed sales lists of taxable goods;

7. If acting as an agent, provide the original ID card of the agent.

To sum up, take all the above information to the relevant departments of the local social security center. Upon examination, if the information is complete and meets the requirements, it will be handled immediately. When applying for reimbursement of outpatient medical expenses, the applicant should first deduct the amount allocated to the personal account of medical insurance in this social security year, and then verify the amount to be reimbursed.

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.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Article 12 of the Notice of Foshan Municipality on the Administration of the Payment of Medical Insurance Benefits.

If the insured person goes to the hospital due to accidents and other reasons, and the third person bears part of the medical expenses, after approval, his medical treatment shall be calculated according to the standards of this Municipality, and the differential medical treatment shall be paid after deducting the expenses borne by the third person. The insured person shall provide the information required for sporadic reimbursement to the social security agency of the insured place to apply. If the required original materials have been collected by a third party, the insured shall provide a copy of the certification materials and materials collected by the third party.