Can self-funded medical insurance be reimbursed?

Legal analysis: 1. Whether to apply for self-funded drug commercial insurance shall be subject to the product terms. Some partners who work in insurance companies still don't understand the reimbursement scope of commercial insurance after helping customers get medical insurance claims, and often have the same idea as customers, why hospitalization costs so much, but claims are few. 2. In fact, as long as hospitalization is needed due to accidents or diseases, the hospitalization expenses incurred are composed of self-funded drugs and social security drugs. Self-funded drugs are drugs that are not recognized by medical insurance such as Class A and Class B in the local medical insurance catalogue, and they are all self-funded drugs. Class A drugs refer to drugs formulated by the state and widely used in clinic, and the expenses are paid according to the provisions of the basic medical insurance measures. 3. Class B drugs refer to drugs that the basic medical insurance fund has the ability to partially pay. The expenses incurred in the use of such drugs shall be paid by the employees themselves first, and then included in the scope of payment of the basic medical insurance fund, and paid according to the provisions of the basic medical insurance. 4. When the patient leaves the hospital, the hospital will provide the patient with a list of hospitalization expenses, which will clearly show the classification of Class A and Class B drugs and self-funded drugs stipulated by the local medical insurance bureau. When we reimburse social security or commercial insurance, the staff will refer to the social security reimbursement regulations and commercial insurance reimbursement regulations for reimbursement. Generally, 65,438+000% of Class A drugs are reimbursed, while Class B drugs are partially reimbursed (ranging from 50% to 80%), and Class C drugs, that is, self-funded drugs, are not reimbursed.

Legal basis: Article 45 of the Constitution of People's Republic of China (PRC) stipulates that People's Republic of China (PRC) citizens have the right to receive material assistance from the state or society in case of old age, illness or disability. The state develops social insurance, social relief and medical and health services that citizens need to enjoy these rights.