How to reimburse the production inspection expenses in Xiamen?

Medical insurance reimbursement process for medical examination expenses in Xiamen;

1. Confirm reimbursement scope: During the treatment, you need to confirm whether your treatment items are within the scope of medical insurance reimbursement;

2. Collect reimbursement materials: collect relevant treatment records, drug receipts, medical expense lists and other relevant materials;

3. Go to the social security department for reimbursement: submit relevant materials for medical insurance reimbursement to the local social security department;

4. Pending review: The social security department will conduct relevant review and comparison to confirm the reimbursement ratio and reimbursement amount; Receive reimbursement: After approval, you can receive medical insurance reimbursement at the designated bank.

Maternity medical insurance reimbursement standards are as follows:

1. If a pregnant woman has purchased comprehensive medical insurance, part of the cost of prenatal examination can be free when she goes to the hospital for prenatal examination;

2. Pregnant women who purchase hospitalization medical insurance can enjoy the corresponding medical insurance benefits when they are hospitalized;

3. If pregnant women buy maternity insurance, they can only enjoy the corresponding maternity insurance benefits after the birth check-up and giving birth to the baby. In the process of birth check-up, most items can be reimbursed, and at the same time, you can also receive a certain maternity allowance and enjoy maternity leave.

Medical insurance reimbursement standard:

1, residents' reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; 30% reimbursement for tertiary hospitals;

2, urban residents, in a settlement year, the medical expenses that meet the scope of reimbursement are 65,438+10,000 yuan, the threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in the first-class hospital, and the reimbursement rate is 60%;

3. You need to go back to your hometown for reimbursement, and the reimbursement rate is 35-65%, which varies according to the level of the hospital.

To sum up, medical insurance for pregnancy examination and production expenses can be reimbursed, generally through maternity insurance expenses. In other words, the cost of pregnancy test is generally carried out in outpatient department and can be reimbursed. Maternity insurance covers the expenses incurred by pregnant women during delivery in hospital. This fee can be directly reimbursed when pregnant women are hospitalized, but this pregnancy check-up fee can be reimbursed.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.