How much can social security be reimbursed?

The amount of social security reimbursement is determined according to specific medical items and social security policies, and cannot be generalized.

First, the basic principles of social security reimbursement

The basic principle of social security reimbursement is "advance before reimbursement", that is, patients need to bear medical expenses first, and then reimburse according to social security policy. Therefore, before seeking medical treatment, patients need to know the social security policies and reimbursement standards in their areas in order to better plan their medical expenses.

Second, the factors affecting the amount of social security reimbursement

The amount of social security reimbursement is influenced by many factors. First of all, different medical projects have different reimbursement rates and upper limits. Generally speaking, the items that can be reimbursed by the basic medical insurance include outpatient service, hospitalization and medicines. However, the specific reimbursement ratio and upper limit will vary according to different regions and policies. Secondly, the hospital grade will also affect the reimbursement amount. Generally speaking, the reimbursement rate of high-grade hospitals will be relatively low, while the reimbursement rate of primary medical institutions will be relatively high. In addition, factors such as the type of personal medical insurance and payment will also have an impact on the reimbursement amount.

Third, the social security reimbursement application process

The application process of social security reimbursement generally includes the following steps: first, patients need to keep all medical expense invoices and related supporting materials when seeking medical treatment; Secondly, the patient needs to apply for reimbursement to the social security agency where the social security is located, fill in the relevant application form and submit the required certification materials; Finally, the social security agency will deposit the amount eligible for reimbursement into the patient's bank account according to the policy review application.

To sum up:

The amount of social security reimbursement is determined according to specific medical items and social security policies, which is influenced by many factors. Patients need to know the social security policies and reimbursement standards in their areas before seeking medical treatment, and properly keep relevant certification materials when seeking medical treatment. When applying for reimbursement, you need to follow the prescribed procedures in order to successfully obtain social security reimbursement.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28 provides that:

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.

People's Republic of China (PRC) social insurance law

Article 29 provides that:

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.