Surgery medical insurance reimbursement is how to reimburse

If we are sick generally need to be treated, so if we have medical insurance when we have surgery, can we be reimbursed? If you want to reimbursement should be how to handle? Below, in order to help you better understand the relevant legal knowledge, I organized the following content, I hope to help you.

A. How to get reimbursed for surgery with medical insurance

1. When you are admitted to or discharged from the hospital, you must go to the medical insurance management window of each designated medical institution with your medical insurance IC card to register for hospitalization. When you are hospitalized, you will have to pay a deposit in advance for the medical expenses, and then you will have to pay more or less after you are discharged from the hospital. Medical fees incurred before hospitalization registration are not covered by basic medical insurance. If you are hospitalized due to an emergency and cannot register for hospitalization in time, you should go to the medical insurance management window on the next day after you are admitted to the hospital with a certificate of emergency to make up for the hospitalization procedures (in case of holidays, the procedures will be postponed), and you will be responsible for the medical fees that exceed the time limit.

2. The starting line of the integrated fund after the hospitalization of the insured: the starting line varies from place to place, generally 10% of the average annual salary of the city's employees in the previous year, in a basic medical insurance billing year, multiple hospitalization of medical fees are calculated cumulatively.

3. Participants need to be referred or transferred to the hospital due to their condition, must be diagnosed by the deputy director of the third level or higher designated medical institutions or the head of the proposed referral (hospital) advice, the unit to fill out an application form, by the designated medical insurance management department of the medical insurance institutions agreed to report to the city (district) social security agencies for approval after the referral (hospital) procedures.

The transfer is limited to the provincial hospitals, the cost of which is first paid by the person, the reimbursement rate to be first 10%, and then calculate the amount of reimbursement in accordance with local regulations.

4. When discharged from a designated medical institution, each designated medical institution will calculate the amount of reimbursement and the amount of personal out-of-pocket payment in accordance with the relevant policies, and the reimbursement will be settled by the designated medical institution and the urban social insurance agency, and the amount of personal out-of-pocket payment will be settled by the designated medical institution and the insured person himself/herself.

Second, health insurance costs

Where the cooperative medical hospitalized patients with a one-time or annual total of more than 5,000 yuan of reimbursement of medical expenses, i.e., 5,001-10,000 yuan of compensation for 65%, 10,001-18,000 yuan of compensation for 70%. Township-level cooperative medical hospitalization and uremia outpatient blood dialysis, outpatient radiotherapy and chemotherapy compensation annual limit of ten thousand yuan.

The above content is related to the answer, usually, if others to do surgery to meet the conditions, it is possible to reimburse the medical insurance, we need to take the medical insurance IC card to the designated medical institutions health insurance management window for entry and exit hospitalization registration procedures.