How much can medical insurance for major diseases be reported?

How much can medical insurance for major diseases be reported as follows:

One-time hospitalization medical expenses for employee's illness or non-work-related injury, or the accumulated part exceeding 2,000 yuan within 30 days, belong to the payment scope of employee's serious illness medical insurance pooling fund, and shall be calculated step by step and paid cumulatively:

1, more than 2000 yuan but less than 5000 yuan, 90% will be paid.

2, more than 5000 yuan 1 ten thousand yuan to pay 85%;

3, 10000 yuan more than 30000 yuan to pay 80%;

4, 30 thousand yuan to 50 thousand yuan to pay 85%;

Pay 90% for 50,000 yuan and above.

Medical insurance reimbursement methods are as follows:

1. Before seeing a doctor: Before seeing a doctor, you need to confirm the type and scope of your medical insurance, choose medical institutions and doctors that meet the medical insurance policy, and ensure that medical expenses can be reimbursed;

2. During medical treatment: during medical treatment, you need to fill in your basic personal information and medical conditions accurately, and provide your medical insurance card and related certification materials to doctors and medical institutions;

3. Reimbursement application: After seeing a doctor, you need to submit an application for reimbursement of medical expenses to the local social insurance management center or medical insurance office, and provide relevant medical expenses bills and supporting materials, such as outpatient invoices, prescription notes, medical records, etc.

4. Reimbursement review: medical insurance institutions review the application for reimbursement of medical expenses, check the information such as expenses and illness, and determine the proportion and amount of reimbursement;

5. Reimbursement payment: After approval, the medical insurance institution will pay the reimbursement amount to the applicant's bank account or medical insurance card.

To sum up, different regions and types of medical insurance may have different reimbursement methods, and the specific reimbursement process needs to be operated according to local policies and regulations. In addition, you need to carefully check your medical insurance information and medical expenses when reimbursing, so as to avoid filling in wrong or false information, so as not to affect the efficiency and accuracy of reimbursement.

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

Employees should participate in the basic medical insurance for employees, and employers and employees should jointly pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 28

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.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.