Gynecological disease medical insurance can be reimbursed

Generally speaking, the current national health insurance can reimburse most of the gynecological medical expenses, but the proportion of the reimbursement costs often vary from different regions, different hospitals to choose and different medical conditions, so you have to focus on each of these issues when examining.

I, the reimbursement process

1. In the local health insurance designated hospitals to see gynecological diseases, to take the initiative to inform the hospital of their own participation in the local social health insurance this matter, and then show the personal health insurance card, and registration of the health insurance card information, in order to facilitate the later in the settlement of the gynecological medical expenses related to the cost of direct deduction or reimbursement;

2. To the outpatient clinic fee office to deposit medical expenses, keep the deposit slip receipt.

3. According to the hospital's procedure, the gynecological examination or treatment will be carried out. If you need to be hospitalized, the condition is cured or improved at a later stage, the doctor will issue a discharge order and handle the discharge summary;

4. After the end of the process of seeing a doctor in the window for settlement procedures, this time before the medical insurance card medical registration, show your medical card again, the hospital will automatically deduct the relevant costs, if it is deducted from the medical card on the integrated account, then you need to collect the medical expenses incurred during the see The first thing you need to do is to collect the invoices of the medical expenses incurred during the period of the gynecological diseases, personal ID card, original medical insurance card and other materials, the expenses will be advanced by the individual, after the social security department through the audit will be in accordance with the agreed time to the amount of medical insurance reimbursement to the applicant's designated bank account.

Medical insurance, generally referred to as basic medical insurance, is a social insurance system established to compensate workers for the economic losses caused by the risk of illness. A medical insurance fund is established through contributions from employers and individuals, and medical insurance organizations provide certain financial compensation to insured persons after they incur medical expenses for sick visits.

The establishment and implementation of the basic medical insurance system gathers the economic strength of the unit and members of society, coupled with the government's financial support, can make the sick members of society from the community to obtain the necessary material help, reduce the burden of medical expenses, to prevent the sick members of society, "due to illness, poverty".

Second, medical insurance reimbursement rate

Medical insurance is mainly divided into employee medical insurance and resident medical insurance, the reimbursement rate is also different. The reimbursement rate of the employee health insurance is divided according to the high and low hospitalization cost, the reimbursement rate between 1300 yuan and 30,000 yuan is 85%, the reimbursement rate between 30,000 yuan and 40,000 yuan is 90%, the reimbursement rate between 40,000 yuan and 100,000 yuan is 95%, and the reimbursement rate between 100,000 yuan and 300,000 yuan is 85%.

The residents' health insurance is a combination of the urban residents' health insurance and the new rural cooperative. The reimbursement rate is: first-class hospitals reimbursement rate of 65%, the starting line is three hundred yuan; second-class hospitals reimbursement rate of 65% for less than six thousand yuan, higher than six thousand yuan reimbursement rate of 80%, of which the county second-class hospitals starting line of four hundred yuan, the city second-class hospitals starting line of six hundred yuan; tertiary hospitals, the county tertiary hospitals starting line of six hundred yuan, the reimbursement rate of 65%, higher than six thousand yuan reimbursement rate of 80%, and city The starting line for tertiary hospitals is eight hundred dollars. The reimbursement rate for hospitals under 12,000 yuan is 55%. Above 12,000 yuan, the reimbursement rate is 75 percent.

Legal basis

The Chinese People's **** and State Social Insurance Law

Article 28 Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and treatment items, and medical service facility standards, as well as those for emergencies and rescues, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29 The part 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 administrative organization with the medical institutions and drug business units. The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance treatment by insured persons.