How much can medical insurance for fracture surgery reimburse?

The medical insurance for fracture surgery can reimburse about 70%. Medical insurance reimbursement process:

1. The agent submits the reimbursement documents and other materials to the social security agency for acceptance;

2. After receiving the application materials, the accepting department shall review, settle accounts and pay;

3. If the social security agency approves the application, the applicant will be reimbursed after receiving the "Social Medical Insurance Medical Expense Reimbursement Form". The medical insurance reimbursement process is relatively simple, and now it has also opened cross-regional medical insurance reimbursement, so you don't have to go back and forth for medical treatment in different places.

Scope and standard of medical insurance reimbursement:

1. Drugs are divided into Class A, Class B and Class C, among which Class A drugs are necessary for clinical treatment and widely used, and the drug expenses of these drugs are reimbursed according to the proportion stipulated by medical insurance. Class B drugs are paid a certain proportion first, and then reimbursed according to medical insurance. The specific reimbursement ratio varies from place to place.

2, diagnosis and treatment project refers to the hospitalization, the use of medical instruments, equipment and medical materials, mainly in two ways, the whole project is included in the scope of medical insurance reimbursement, according to the provisions of the proportion of payment. As a whole, part of the project is paid in advance, and then reimbursed according to the prescribed proportion;

3, medical service facilities standards, refers to the hospital bed fees, outpatient and emergency observation bed fees, etc., the scope and standards of reimbursement vary from place to place. In terms of social security, the scope of medical insurance reimbursement is the items in the medical insurance catalogue, including medicines, medical treatment items and medical service facilities.

Legal basis: Article 2 of People's Republic of China (PRC) Social Insurance Law.

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 28

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.