After participating in social security, I am hospitalized for surgery, and I don't have to pay for medical expenses at my own expense?

No, it's only within the scope of medical insurance, and you don't need the full amount.

Legal analysis

Medical insurance can be used for reimbursement of outpatient expenses during outpatient service or hospitalization. You need to see a doctor in a designated medical insurance hospital, and the amount of outpatient expenses can be accumulated. After reaching the minimum threshold of medical insurance reimbursement, you can use medical insurance reimbursement, but the threshold of medical insurance reimbursement will be different in different places. The specific threshold and amount of medical insurance reimbursement need to be consulted with local hospitals or social security institutions.

At the same time, the medical insurance card can also reimburse the hospitalization expenses during hospitalization. Generally, the balance can be deducted directly from the medical insurance card when paying. If the amount is not enough, there is a reimbursement threshold, just like outpatient reimbursement expenses. The specific reimbursement ratio also needs to consult the local hospital or social security agency.

Can the operation fee be reimbursed?

_ Whether the operation fee can be reimbursed depends on the situation, which is mainly divided into three categories.

1. Scope of diagnosis and treatment items not covered by basic medical insurance: organ sources or tissues of various organ or tissue transplants; Various beauty and bodybuilding projects and non-functional beauty and plastic surgery; Orthopedics of myopia.

2, the basic medical insurance to pay part of the cost of diagnosis and treatment project scope: pacemaker, artificial joint, intraocular lens, vascular stent and other artificial organs in vivo replacement, in vivo placement of materials; Kidney, heart valve, cornea, skin, blood vessels, bone and bone marrow transplantation; Cardiac laser drilling, anti-tumor cellular immunotherapy and fast neutron therapy projects; Hemodialysis, peritoneal dialysis.

3. Normal scope of basic medical insurance: In addition to the scope of medical treatment items that do not pay the fees and the scope of medical treatment items that pay part of the fees, according to the document Opinions of the Ministry of Labor and Social Security, the State Planning Commission, the Ministry of Finance, the Ministry of Health and state administration of traditional chinese medicine on Determining the Scope of Medical Service Facilities and Payment Standards of Basic Medical Insurance for Urban Employees, if the medical expenses incurred by the insured in the designated medical institutions in this city fall within the scope of payment by the urban and rural residents' medical insurance fund, they shall be accounted by the designated medical institutions and paid by the urban and rural residents' medical insurance fund according to regulations.

If the insured fails to go through the referral procedures or does not carry the medical certificate, the medical expenses incurred in the outpatient service of the designated medical institutions in this Municipality will not be settled; After the medical expenses incurred in emergency medical treatment are paid by individuals in cash, they can apply for reimbursement to the agency in accordance with the regulations with the medical certificate, medical expense receipt and relevant medical history materials within 3 months.