How to inquire about medical insurance reimbursement

Medical insurance reimbursement query method:

1, local query. Insured persons can directly bring their identity documents and resident medical insurance cards to the service hall of the local social security bureau to print the payment list, and can inquire about relevant information in detail;

2. Telephone inquiry. Insured persons can call the Social Security Bureau directly 12333 for enquiry.

Medical insurance coverage:

1, reimbursement of basic medical insurance drugs: our country now divides drugs into three categories: A, B and C, of which A drugs are within the scope of medical insurance, so medical insurance can only reimburse A drugs, and B and C drugs cannot be reimbursed;

2. Reimbursement of basic medical service facilities: this reimbursement scope mainly refers to bed fees, first-aid bed fees, medical treatment fees, etc. Expenses incurred by the insured in the process of medical treatment and nursing in designated medical insurance institutions;

3. Reimbursement of basic medical insurance diagnosis and treatment items: it must be a safe and effective diagnosis and treatment item, and the charging standard shall be determined by the price department. Need to be treated in a designated medical institution.

Medical insurance reimbursement process:

1, diagnosis and treatment in designated medical insurance hospitals: every city will have designated medical insurance hospitals, and only in designated medical insurance hospitals can medical insurance be used for reimbursement. Therefore, if you want to use medical insurance, you must go to the designated hospital for medical insurance and go through the relevant registration procedures;

2. Prepare discharge materials: prepare discharge materials in advance when leaving the hospital, such as disease diagnosis, discharge records, medical records, etc. Usually talk to the doctor during treatment. If we need these materials, the doctor will help us prepare them. You'd better make a copy of these materials after you get them. One is submitted to the medical insurance reimbursement office, and the other is reserved for use;

3. Discharge settlement: Take the hospitalization list and invoice and go to the hospital for settlement. After that, you can take the relevant information to the medical insurance reimbursement department for reimbursement review;

4. Waiting for expense reimbursement to arrive: After the materials are handed over, a receipt will be received, and the reimbursement amount will arrive in 15 days. You just have to wait patiently.

To sum up, the medical insurance reimbursement inquiry can be served by the local social security bureau or by telephone.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.