Can employee medical insurance reimburse gynecological examination fees and treatment fees?

Employee medical insurance can reimburse gynecological examination fees and treatment fees.

As long as the drugs used are within the scope of basic medical insurance reimbursement, they can be reimbursed through medical insurance. General medical expenses are paid by the basic medical insurance fund. Because of gynecological hospitalization surgery, the medical expenses incurred can also be reimbursed through medical insurance.

The medical insurance card will be provided directly when you go to the hospital for treatment, and the staff of the medical insurance office will reimburse you when you settle the account. Of course, generally not all expenses can be reimbursed. After all, some of them may not be covered by medical insurance reimbursement and need to be paid at their own expense.

And we also need to pay attention to one thing. If you want to reimburse, you must go to a medical institution designated by medical insurance to seek medical treatment before you can reimburse.

Medical insurance reimbursement process:

1, diagnosed and treated in the designated medical insurance hospital.

Every city will have designated hospitals for medical insurance. Only when you are treated in a designated medical insurance hospital can you be reimbursed by medical insurance. Therefore, if you want to use medical insurance, you must go to the designated hospital for medical insurance and go through the relevant registration procedures;

2. Prepare discharge information

Prepare discharge materials in advance when you leave the hospital, such as disease diagnosis, discharge records, medical records, etc. Usually talk to the doctor during treatment. If we need these materials, the doctor will help us prepare them. You'd better make a copy of these materials after you get them. One is submitted to the medical insurance reimbursement office, and the other is reserved for use;

3. Discharge settlement

Take the hospitalization list and invoice to the hospital for settlement. After that, you can take the relevant information to the medical insurance reimbursement department for reimbursement review;

4. Wait for the expense reimbursement to arrive.

A receipt will be received after the data is handed over, and the reimbursement amount will be received within 15 days. You just have to wait patiently.

To sum up, most medical expenses of gynecological diseases can be reimbursed through medical insurance cards, but the reimbursement ratio is different. Therefore, it is best for insured citizens to take the initiative to consult the local social security bureau to safeguard their legitimate rights and interests.

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.

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.