Job Recruitment Website - Social security inquiry - Will commercial insurance be reimbursed after medical insurance reimbursement?

Will commercial insurance be reimbursed after medical insurance reimbursement?

The answer is yes, we should follow the principle of social security first and commercial insurance later. If the social security reimbursement amount is not 100%, commercial insurance can still provide reimbursement, and the reimbursement standard is calculated according to the terms.

There are many restrictions on reimbursement of cooperative medical care. Only part of the amount can be reimbursed after hospitalization, and the rest cannot be reimbursed to the insurance company.

Commercial insurance can reimburse more self-funded drugs and special treatment costs.

There are serious illness insurance in commercial insurance, all of which are paid directly. Once a major disease occurs, hundreds of thousands of compensation will be paid at the beginning. If you are disabled and accidentally insured for hundreds of thousands, you will pay according to the level of disability. Social security or cooperative medical care and commercial insurance are complementary.

First through social security reimbursement, indicating that commercial insurance reimbursement is also needed. The maximum reimbursement amount is the sum of the amount reimbursed by social security or other means plus the amount reimbursed by insurance companies, and shall not exceed the actual medical expenses;

If the social security has been reimbursed, but the original documents of medical expenses can't be provided, the reimbursement institution can sign for approval, clearly list the original amount, the original proof of reimbursement amount, the copy of medical expenses receipt, and attach a detailed list of expenses, which is also recognized by the insurance company.

Note that if there is only one document, the original should be used for social security reimbursement, and the copy can be used for commercial medical insurance.

It should be noted that reimbursement of medical insurance belongs to the nature of reimbursement. According to the principle of cost compensation, the total amount of medical insurance reimbursement and commercial medical insurance reimbursement in social security cannot be higher than the total amount of actual medical expenses.

To sum up, employee medical insurance and commercial insurance are reimbursed in sequence. When reimbursing, employees' medical insurance shall be reimbursed first, and then commercial insurance shall be insured. Medical insurance and commercial insurance cannot be reimbursed at the same time. However, it should be noted that the total reimbursement of employee medical insurance and commercial insurance cannot be higher than the actual total medical expenses.