How to reimburse after fracture of bone plate?

Medical insurance reimbursement for orthopedic surgery steel plate expenses:

1. If it is basic medical insurance, it will not be reimbursed, but it can be paid with the money in the personal account of medical insurance;

2. If it is commercial medical insurance, the cost of orthopedic surgery steel plate can be reimbursed by medical insurance. After all, it belongs to self-funded medical expenses. For example, one million medical insurance can reimburse the cost of orthopedic surgery steel plate, but only if the related medical expenses exceed the deductible of medical insurance.

Medical insurance reimbursement process:

1. The parties shall go to the hospital to go through the medical insurance networking formalities with valid certificates such as medical insurance card or ID card and household registration book, and go through the settlement formalities directly when they leave the hospital;

2. Or bring all relevant materials to the relevant departments of the local social security center. Those who meet the requirements after the completion of the audit can be settled immediately.

Classification of medical insurance:

1, indirect medical insurance system. Government social insurance institutions sign contracts with private medical institutions, and patients pay their own medical expenses first, and then reimburse all or part of the expenses to social insurance institutions. This system is very common in western industrialized countries.

2. Direct medical insurance system. The government directly owns and manages medical institutions, and all or part of the medical expenses of workers are borne by the state. This system is quite common in socialist countries.

3. Basic medical care. Namely prevention, treatment and comprehensive health insurance services. Including improving nutrition, sanitary water supply, maternal and child health care, immunization of major infectious diseases, prevention and control of epidemic diseases and treatment of common diseases. This system is very common in developing countries. The conditions for enjoying medical insurance are determined according to the number of years of employment or the number of years of paying insurance premiums. Usually, the qualification of medical insurance is matched with sickness insurance, and those who enjoy cash subsidies from sickness insurance can enjoy medical services. China's current medical insurance system is divided into public medical system implemented by state organs and institutions and labor insurance medical system implemented by enterprises. Medical expenses are borne by the state or enterprises, and the method of individual paying part of the expenses began to be tried out in the late 1980 s.

To sum up, the cost of orthopedic surgery steel plate is reimbursed by medical insurance, but it should be reimbursed in proportion.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.