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Is it necessary to have a diagnosis certificate for insurance reimbursement?
Medical insurance has always been a concern of all of us, and it is also a problem that has been bothering us. Medical insurance gradually benefits urban and rural life and can be used and reimbursed in different places. The scope of medical insurance reimbursement is limited.
1. What do you need for insurance reimbursement?
In general, the method of reimbursement for patients' medical insurance is very simple. After hospitalization, when the patient is discharged from the hospital to pay for medical expenses, the part that can be reimbursed has been paid by the overall fund, and the patient only needs to pay the part at his own expense. If the patient has special circumstances and cannot be settled immediately after discharge, he can apply for medical insurance reimbursement at the local medical insurance center with medical records, diagnosis documents, charge bills, discharge summary, expense list, medical insurance card and other materials after discharge.
Second, relevant laws.
1, Article 20 of the Labor Law stipulates: "The state develops social insurance undertakings, establishes a social insurance system and sets up a social insurance fund, so that workers can get help and compensation in cases of old age, illness, work injury, unemployment and maternity."
2. Paragraph 1 of Article 26 stipulates: "If a worker is sick or injured non-work-related, and cannot engage in the original work or other work arranged by the employer after the medical treatment expires, the employer may terminate the labor contract, but it shall notify the worker himself in writing 30 days in advance."
3. Article 29 stipulates that during the prescribed medical treatment period, the employer shall not terminate the labor contract in accordance with the provisions of Articles 26 and 27 of this Law.
4. Article 7 1 stipulates: "The level of social insurance should be compatible with the level of economic development and social affordability." Article 72 stipulates: "The social insurance fund shall determine the source of funds according to the types of insurance and gradually implement overall planning. Employers and workers must participate in social insurance and pay social insurance premiums according to law. "
5. Article 73 stipulates that workers shall enjoy social insurance benefits according to law in case of retirement, illness, work-related injury, work-related disability or occupational disease, unemployment and maternity.
6. Article 74 stipulates that social insurance fund agencies shall collect, manage and operate social insurance funds according to law, and be responsible for maintaining and increasing the value of social insurance funds; Social insurance fund supervision institutions shall supervise the income and expenditure, management and operation of social insurance funds according to law; The functions of handling social insurance funds and establishing social insurance fund supervision institutions are stipulated by law, and no organization or individual may misappropriate social insurance funds.
7. Article 75 stipulates: "The state encourages employers to establish supplementary insurance for workers according to actual conditions; The state encourages individual workers to participate in savings insurance. "
8. Article 100 stipulates: "If the employer fails to pay social insurance premiums without reason, the labor administrative department shall order it to pay within a time limit; If you fail to pay within the time limit, you can add a late fee. "
9. Article 104 stipulates: "State functionaries and staff of social insurance fund agencies who misappropriate social insurance funds, which constitutes a crime, shall be investigated for criminal responsibility according to law." However, pay attention to the age limit. Nowadays, many insurances have relevant conditions when they are actually purchased, and age is a very important aspect. Only by knowing yourself in time can we trust and realize our real value.
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