Hello, my baby is a newborn baby. The hospitalization expenses were more than 65438+3000, and the rural social security reported 7000.

The Social Insurance Law stipulates that if a newborn mother is insured in that year, the newborn can be automatically included in medical insurance from the date of birth, and enjoy the treatment of cooperative medical insurance for urban and rural residents with her mother. The reimbursement of medical expenses incurred in the year of childbirth shall be calculated with the mother until the highest capping line.

Medical insurance refers to the basic medical insurance premium paid in full and on time by employers and employees according to the principle of compulsory social insurance through national legislation. If it is not paid in full and on time, the basic medical insurance fund will not pay its medical expenses regardless of individual accounts.

Medical insurance is insurance to compensate medical expenses caused by diseases. Social insurance in which employees are provided with necessary medical services or material assistance by society or enterprises due to illness, injury or childbirth. For example, free medical care and labor insurance medical care in China.

The medical expenses of employees in China are shared by the state, units and individuals to reduce the burden on enterprises and avoid waste. Insurance liability accidents need to be handled, and the insurance money will be paid in proportion.

Proportion of medical insurance reimbursement:

1, outpatient and emergency medical expenses: the medical expenses that met the requirements of the basic medical insurance in that year (1 10/February/31February) exceeded 2,000 yuan.

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.

4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.

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