What is the reimbursement rate of Shenzhen medical insurance for medical treatment in different places

The proportion of medical insurance reimbursement in Shenzhen is 90%-95%.

First-class outpatient reimbursement: 70% for individual account and 30% for overall fund according to regulations. First-class hospitalization reimbursement: 95% or 90% is paid for the part above the deductible. Those who have gone through the procedures of referral or filing shall be accounted for according to the above proportion. Did not apply for referral or filing procedures, according to the above payment standard of 90%.

The process of medical insurance reimbursement:

1, medical treatment: go to a hospital or clinic for medical treatment or treatment;

2. Payment: Pay the medical expenses that should be paid in the hospital or clinic;

3. Obtain a list of expenses: during the medical treatment, the hospital or clinic will provide a list of expenses, which lists the specific medical items and amount;

4. Fill in the reimbursement application form: hold the expense list and fill in the medical insurance reimbursement application form. You need to provide your own basic information, medical expenses list, medical insurance certificate and other related materials when filling in;

5. Submit materials: submit the completed reimbursement application form and related materials to the medical insurance agency, which can be submitted online or offline;

6. Audit: The medical insurance agency shall audit the submitted application forms and materials. After the approval, the medical insurance agency will transfer the reimbursement to the personal bank account or give cash reimbursement.

To sum up, in the process of reimbursement of medical expenses, the insured should abide by the relevant regulations, such as not making false reports or reimbursing in disguise, so as to avoid unnecessary losses in violation of the relevant regulations.

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.