Where is the medical insurance reimbursed?

Medical insurance is divided into urban and rural residents' medical insurance and workers' medical insurance, which belongs to one of the five insurances of social insurance. No matter what kind of medical insurance, it can only be reimbursed if it is treated in a local designated hospital. As for where to go for reimbursement, there are the following situations for reference:

1. If you are hospitalized in a local designated medical insurance institution, the hospital will automatically reimburse you when you check out;

2. If you are not hospitalized and have not been reimbursed for medical treatment, you need to bring the hospitalization settlement invoice, medical certificate, expense details and social security card to the local government affairs center or the medical insurance window of the social security center for reimbursement; If you are treated in other medical institutions, you need to provide a referral certificate.

Medical insurance will not be reimbursed if:

1. It should have been paid by individuals;

2. Expenses incurred for treatment abroad or in Hong Kong, Macao and Taiwan;

3. There are illegal acts such as fighting and drinking, or injuries caused by suicide, traffic accidents or medical accidents;

4 non designated medical institutions or non designated retail pharmacies to buy drugs.

legal ground

People's Republic of China (PRC) social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.