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How to reimburse medical insurance for accidental fracture surgery?
Legal analysis: medical insurance reimbursement is carried out in proportion, generally floating around 70%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
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