Can examination fees be reimbursed by medical insurance

Whether the medical insurance examination fee can be reimbursed depends on the actual situation, such as:

1. If it is the basic medical insurance, then it can be reimbursed for the examination fee within the scope of the medical insurance, but if it is the out-of-pocket medical expenses, such as the CT examination fee, it belongs to the out-of-pocket medical expenses outside of the medical insurance, which need to be borne by the participant, and is not reimbursed by the basic medical insurance. However, if you have money in your personal account, you can use it to pay for the out-of-pocket medical expenses directly;

2. In the case of outpatient emergency insurance, although it can reimburse the insured for the costs of outpatient emergency examinations, it only reimburses for the costs of the examinations within the medical insurance policy, but not for the out-of-pocket costs of the examinations outside of the medical insurance policy;

3. The first is that it is possible to reimburse outpatient medical expenses before and after the hospitalization, for example, some million medical insurance can reimburse outpatient medical expenses 7 days before and 30 days after the hospitalization, that is to say, it can reimburse outpatient medical expenses incurred in the emergency room 7 days before and 30 days after the hospitalization. In addition, if it is reasonable and necessary examination costs incurred during the hospitalization, the million medical insurance can also generally be reimbursed, but in the reimbursement needs to be deducted from the deductible before reimbursement in accordance with the agreed proportion of the insurance contract.

The process of urban and rural residents' health insurance:

1, the form and fill in the form of registration, the insurance unit operator will be "social security (citizen) card application form" double-sided copy to each new participant, and guide the new participant to fill in the application form in accordance with the requirements of the rules of the application.

2. Before the 3rd day of the month following the month of registration, the operator of the insured unit will arrange for the newly insured person to bring his ID card (or military officer's card or passport) to the designated photo studio of the Social Security (Citizen) Card to take a digital photo of the Social Security (Citizen) Card, and paste the photo receipt in the corresponding position of the application form. The fee for taking a photo of your Social Security (Citizen) Card is 4 yuan per visit.

3. To collect the application form and the labor cost, the operator of the insured unit is requested to collect the completed Social Security (Citizen) Card Application Form for new participants before the 19th day of the following month of the registration, and at the same time collect the labor cost of the Social Security (Citizen) Card of RMB 20 yuan per person.

4, hand over the form, payment and card health insurance account bank will notify the insured units in the insurance registration after the 19th day of the following month, go to the municipal health insurance center for handing over the form, payment and card procedures. The process of submitting the form, paying the fee and receiving the card: can be centralized in the medical insurance center service hall designated window.

5. The operator of the card-issuing participant unit must issue the social security (citizen) card to the participant within one week after receiving the card.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 32: If an individual is employed across the co-ordinated area, his/her basic medical insurance relationship shall be transferred with him/her, and his/her years of contribution shall be cumulative.

Article 31 The social insurance administration organization may, according to the needs of management services, sign service agreements with medical institutions and drug business units to regulate the behavior of medical services. Medical institutions shall provide reasonable and necessary medical services to the insured.

Article 58 An employer shall, within thirty days from the date of employment, apply for social insurance registration with the social insurance administration organization for its employees. If the employer fails to register for social insurance, the social insurance agency shall approve the social insurance premiums to be paid by the employer. Individual entrepreneurs without employees who voluntarily participate in social insurance, part-time workers who do not participate in social insurance with their employers, and other flexibly employed persons shall apply for social insurance registration with the social insurance administration organization. The State establishes a nationally unified individual social security number. Individual social security numbers are citizens' identity numbers.