How to reimburse medical expenses for social security in a different place

The process of reimbursement of medical expenses by social security in a different place is generally as follows:

1, medical treatment: when seeking medical treatment in a different place, you need to keep the invoices of medical expenses and medical certificates and other related materials;

2, reimbursement application: after returning to the local area, you need to apply for reimbursement of medical expenses to the local social security institution within the specified time. You can declare online through social security card, medical insurance APP, etc., or go to the window of the social security institution for offline declaration;

3. Data review: the social security institution will review the declared data, including medical expense invoices, medical certificates, reimbursement application forms and other materials, to determine whether they meet the reimbursement conditions and standards;

4. Reimbursement processing: after the review is passed, the social security organization will reimburse the medical expenses that meet the criteria, and will usually transfer the reimbursement directly to the individual's bank card.

The scope of reimbursement for social security medical insurance is as follows:

1. The scope of reimbursement for residents' medical insurance: including general outpatient reimbursement, major disease reimbursement and special outpatient reimbursement;

2. The scope of reimbursement for employees' medical insurance: divided into the co-ordination account and individual account, the co-ordination account can reimburse inpatient medical expenses, special outpatient medical expenses, etc., and the individual account can directly pay for general outpatient, Individual accounts can directly pay for general outpatient services, the cost of medicines purchased at designated pharmacies, and the personal out-of-pocket portion of hospitalized medical expenses.

In summary, there may be differences in the reimbursement process and standards of social security in different regions, and the specific requirements should be based on the regulations of the local social security institutions. At the same time, it is recommended to know the local health insurance policies and reimbursement standards in advance before seeking medical treatment in a different place, so as to avoid unnecessary expenses.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses that are in line with the basic medical insurance drug directory, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.