How to reimburse Shenzhen medical insurance after out-of-pocket expenses?

1. How to reimburse the out-of-pocket expenses of Shenzhen medical insurance clinic?

With the medical certificate or expense receipt from the hospital, according to your social security office, you will be reimbursed at the specified time. Generally, the documents are submitted first, and the fee will be refunded after a period of time.

Medical reimbursement for low-income workers can be reimbursed for medical expenses in proportion according to the provisions of the new rural cooperative medical system. As a low-income household, you can also enjoy the corresponding medical assistance. Insured persons should seek medical treatment in designated medical institutions, and can directly settle accounts at the settlement window of designated hospitals with relevant information when leaving the hospital. Medical expenses that are not treated or hospitalized in designated hospitals will not be reimbursed.

People's Republic of China (PRC) Social Insurance Law Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance to protect citizens' right to get material help from the state and society in the event of old age, illness, industrial injury, unemployment and maternity.

Second, Shenzhen medical insurance card outpatient reimbursement process

When reimbursing, you must bring the following information:

1. Original ID card or social security card;

2. The original disease diagnosis certificate issued by the designated medical institution;

3. Outpatient medical records, inspection, test results report and other medical materials;

4. Original receipt of outpatient charges of medical institutions with unified finance and taxation;

5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;

6. Designated pharmacies: unified original invoices and computer-printed sales lists of taxable goods; 7. If it is an agent, you need to provide the original ID card of the agent. Reimbursement process: bring all the above information to the relevant departments of the local social security center for application. Upon examination, if the information is complete and meets the requirements, it can be handled immediately.

When applying for reimbursement of outpatient medical expenses, the applicant should first deduct the amount allocated to the personal account of medical insurance in this social security year, and then verify the amount to be reimbursed.

Because each local policy is different, you can call the social security number 12333 for consultation.

Legal basis:

Article 28 of the Social Insurance Law conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid by the basic medical insurance fund in accordance with state regulations. Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope: (1) should be paid by the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be borne by public health; (4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.