How to reimburse medical expenses

1. Social security medical insurance is the basic medical insurance provided by the state for all workers who participate in social insurance. This insurance company has to pay 10% of the personal salary to the social security center every month, and the individual has to pay 2% of the salary (both the personal payment and the company payment are returned to the personal medical insurance passbook of Bank of Beijing).

2. Reimbursement ratio: outpatient service: accumulated throughout the year 1800 yuan pays all the following parts; 50% of the annual accumulated 1800 yuan portion can be reimbursed. The part that accumulated more than 20,000 yuan in the whole year: all turned over. Hospitalization: 1300 yuan pays for the following part; 1The part above 300 yuan can be reimbursed from 85% to 97% according to the level and amount of the hospital. More than 70,000 yuan: paid in full.

3. Limitation of hospitalization reimbursement: four designated medical institutions selected in the medical blueprint; Beijing designated 19 Class A designated medical institutions (attached); All specialties and traditional Chinese medicine hospitals in Beijing.

4. Reimbursement time: (1) Outpatient service: When the accumulated amount exceeds 1800 yuan, it will be submitted to the Social Security Center for reimbursement by the Human Resources Department. (2) Hospitalization: direct reimbursement through hospital settlement.

5. Materials to be provided for reimbursement: medical blueprints, registration forms, receipts, prescriptions, laboratory tests, special inspection certificates, etc.

In addition, if you seek medical treatment locally, you can directly reimburse when you leave the hospital, and you only need to pay part of the hospitalization expenses yourself.

If the hospital can't directly reimburse, it needs to bring ID card, household registration book, case, hospitalization record and medical expense list to the local medical insurance center to apply for reimbursement.

If you are seeking medical treatment in a different place, you should not only bring the above materials, but also provide proof of work before reimbursement.

In addition, it should be noted that:

1, which can only be reimbursed if it exceeds the deductible line.

There are deductible lines and capping lines for medical insurance reimbursement. Only those medical expenses that exceed the deductible and fall below the capping line can be reimbursed. Medical insurance reimbursement is also proportional, and the rest still have to be reimbursed at their own expense. Moreover, medical insurance drugs can only be reimbursed in the medical insurance catalogue.

2. Reimbursement should not be overtime.

When you leave the hospital, you must remember to bring your social security card and medical insurance card to settle the expenses. If you can't settle the expenses in time, you can settle the account first, and then submit the medical expenses to the medical insurance department manually with the documents and vouchers. In addition, there is a time limit for reimbursement, and you have to bear it yourself after the time limit. However, at present, many cities have opened the service of buying medicines online with medical insurance cards. You can consult the local social security bureau for details.

Legal basis:

According to the Social Insurance Law of People's Republic of China (PRC)

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.