Medical insurance reimbursement process for hospitalized children in different places

The medical insurance reimbursement process for hospitalized children in different places is as follows:

1, the insured person brings the discharge summary, invoice, medication list issued by a different hospital and the medical certificate issued by the unit to the local social security agency for reimbursement.

2. Used for hospitalization expenses, medicine expenses, etc. Compensation can also be reimbursed by local social security agencies.

The scope of medical insurance reimbursement includes:

1, medical expenses during rescue;

2. Medical expenses during hospitalization;

3, surgical materials and AIDS;

4. Bed fee: according to local medical insurance standards. Except those who need to be admitted to ICU due to acute craniocerebral injury and complex visceral injury, they should be transferred to the general ward immediately after they are out of danger;

5. Rehabilitation physiotherapy fee: according to local medical insurance standards. In principle, there are no more than three kinds, and rehabilitation physiotherapy outside the scope of medical insurance will not be compensated;

6, dressing change and rehabilitation function guidance training: according to local medical insurance standards combined with disease needs;

7. Ambulance fee: calculated according to the standard approved by local health department and price department;

8. Other expenses: expenses that are not compensated according to regulations will not be compensated;

9. Continuing medical expenses: In order to close the case in advance, the insured can pay the necessary continuing medical expenses for the injured in the future in advance. Only when the discharge certificate or diagnosis certificate clearly indicates that the competent doctor needs to continue treatment, or the internal fixator is removed after half a year or one year, or the follow-up treatment expenses are reviewed or recorded regularly, and the compensation payment voucher provided by the insurance record for the follow-up expenses can be reviewed. According to the needs of the disease, obviously beyond the needs of the disease, the audit fee for continuing medical treatment will not be compensated.

To sum up, medical insurance policies and regulations in different regions may be different, and the specific policies and usage methods of electronic medical insurance vouchers may also be different. It is recommended to consult the local social security bureau or medical insurance department to understand the specific policies and use procedures.

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 28

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