Medical insurance and insurance can be used together

Medicare and insurance in general can not be reimbursed at the same time, generally are first reimbursement of medical insurance after reimbursement of insurance, because the medical insurance is not all the amount can be reimbursed, medical insurance is the first to reach the amount of money required by law can be reimbursed, and medical insurance in some cases can not be reimbursed, and this part of the part can not be reimbursed, are generally reimbursed through the insurance.

Medicare reimbursement is as follows:

1. The reimbursement of the medical insurance card is limited to the medical expenses above hospitalization in designated hospitals due to illness and some accidents. The reimbursement formula is: (total cost - threshold fee - out-of-pocket expenses - overspending) (75 + age 0.2)%, under normal circumstances, the actual reimbursement rate ranges from 20 to 60%. Out-of-pocket expenses are not reimbursed, Class B drugs are reimbursed at 80%, there is a limit on the bed charge, and some examination and treatment fees are not reimbursed according to the regulations;

2. The reimbursement amount of the medical insurance card is 4 times of the average salary of the local social workers (the cumulative value within 1 year);

3. The money in the medical insurance card can be used to buy medicines from the designated pharmacies and to pay for the expenses of the outpatient and emergency clinics but it is not a part of reimbursement, since the The money in the card is the money in the individual account of the medical insurance;

4. The major disease insurance reimbursement of the participant suffering from a serious illness, the individual portion of the out-of-pocket expenses incurred in the designated medical institutions of the city medical insurance and in accordance with the provisions of the city's medical insurance are included in the scope of the payment of the residents of the major disease insurance, and 50% reimbursement is made by the funds of the major disease insurance.

In summary, health insurance and commercial insurance in the reimbursement to follow the principle of priority, should be the first social security and then commercial insurance. In the reimbursement, often have to first through the social security reimbursement after the reimbursement, the reimbursement also need to explain to the staff through the commercial insurance reimbursement. Because social security has a starting standard line in many places can not be reimbursed. And these unreimbursable parts can be reimbursed through commercial insurance. Therefore, the policyholder should take the non-reimbursable bills, to the commercial insurance company for reimbursement can be, if there is only a single case, the medical insurance reimbursement can be used in the original, while the commercial insurance reimbursement can be used in the photocopy of the.

Legal basis:

Article 29 of the Social Insurance Law of the People's Republic of China

The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance agency with the medical institutions and the pharmaceutical companies.