Can Shenyang Children's Medical Insurance Clinic be reimbursed?

Can Shenyang Children's Medical Insurance Clinic be reimbursed?

Children's medical insurance clinics in Shenyang can be reimbursed, but certain conditions need to be met. Specifically, children who seek medical treatment in designated medical institutions can enjoy medical insurance reimbursement if the expenses within the scope of medical insurance reimbursement reach a certain standard.

Shenyang children's medical insurance outpatient reimbursement needs to meet the following conditions:

1. Children need medical treatment in designated medical institutions in Shenyang, including community health service centers, township hospitals and clinics.

2. The expenses that meet the scope of medical insurance reimbursement need to meet certain standards, and the specific standards may be different for different medical institutions. Generally speaking, the part of a single outpatient fee below a certain amount needs to be paid at its own expense, and the part that exceeds it can be reimbursed according to a certain proportion.

3. Children need to pay medical insurance fees according to regulations. If they don't pay the medical insurance fee or the medical insurance is interrupted, they can't enjoy the medical insurance reimbursement.

Specifically, the Qifubiaozhun and reimbursement ratio for outpatient reimbursement of children's medical insurance in Shenyang are as follows:

Qifubiaozhun for reimbursement: 600 yuan/year.

Reimbursement ratio: the reimbursement ratio of first-class designated medical institutions is 75%, that of second-class designated medical institutions is 70%, and that of third-class designated medical institutions is 50%.

In addition, it should be noted that if children seek medical treatment in non-designated medical institutions, or medical expenses do not meet the minimum threshold, or exceed the scope of medical insurance reimbursement, they will not be able to enjoy medical insurance reimbursement.

To sum up, Shenyang children's medical insurance clinic can be reimbursed, but it needs to meet certain conditions. Parents should pay attention to choosing designated medical institutions when taking their children to see a doctor, understand the scope and process of medical insurance reimbursement, and better enjoy medical insurance benefits.

Legal basis:

Article 23 of the Measures for the Basic Medical Insurance for Urban Residents in Shenyang stipulates: "Insured persons shall show their social security cards when they are hospitalized in this city. Designated medical institutions shall make real-time settlement through credit cards. The hospitalization medical expenses incurred by the insured shall be paid by the medical insurance fund according to the regulations. "

Article 24 of the Measures for the Basic Medical Insurance for Urban Residents in Shenyang stipulates: "The outpatient special examination, special treatment and hospitalization expenses incurred by the insured due to illness shall be paid by the individual in advance, and the medical insurance agency shall pay according to the prescribed standards with the invoice of outpatient medical expenses, hospitalization medical expenses documents, outpatient medical records, home page of hospitalization medical records, long-term medical orders, temporary medical orders, detailed list of expenses and social security cards."