How is Zhongshan Social Security reimbursed? Do I need hospitalization reimbursement?

Whether hospitalization can only be reimbursed in social security depends on your specific situation. The difference between medical insurance drugs and non-medical insurance drugs, reimbursement deductible line is also different according to hospital level.

Generally, Class A drugs can enjoy full coverage, while Class C drugs need to bear all the expenses, while Class B drugs will be charged 80% and bear 20% of the expenses. Medical insurance also has exclusions, and the following ten items are not within the scope of medical insurance reimbursement. Special medical expenses include organ and tissue transplantation due to illness, organ and tissue purchase and use of anti-rejection drugs and immunomodulatory drugs outside the scope of medical insurance reimbursement for Zhenjiang employees; Work-related injuries and occupational diseases; Maternity of female workers; Rogue fights; Injury caused by alcoholism; Traffic accidents; Others intentionally hurt; Medical malpractice; Beauty and health examination; Other expenses not paid by the social medical insurance fund.

Policy provisions on reimbursement of medical expenses incurred by insured employees in business trips, family visits and long-term residence in different places: 1. Insured employees traveling on business or visiting relatives in other places will only be reimbursed for emergency expenses in other places that meet the requirements of medical insurance, and all expenses will not be reimbursed for non-emergency hospitalization. 2, the insured workers living in the field for more than 6 months, according to the nature of long-term living in the field of medical expenses. 3. Long-term residents in other places should be certified by the unit, and two designated hospitals (which should be designated medical institutions for local medical insurance) should be identified, and the medical expense reimbursement card for long-term residents in other places in Zhenjiang City should be handled in time. 4. Long-term residents in other places must adhere to the principle of economy and prescribe drugs in a limited amount according to regulations (the acute dose is within 3 days, the chronic dose is within 10 days, and the dose of tuberculosis, hypertension and diabetes can be extended to 30 days). 5, long-term residence in the field of referral, need to be signed by the local designated hospitals, step by step according to the principle of territoriality, referral hospital for the city's medical insurance to determine the special hospital. The individual pays 65438+ 00% of the total expenses first, and then reimburses the expenses according to the medical insurance regulations. Other hospitals and individuals pay 20% of the total expenses first, and then reimburse medical expenses according to medical insurance regulations.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.