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Can hundreds of dollars be reimbursed for social security clinics?
The problem of reimbursement of several hundred yuan for social security clinics is mainly decided by local hospitals and social security departments. Generally speaking, the amount and proportion of social security reimbursement for outpatient expenses are stipulated by the local medical insurance department, and the standards in different regions and hospitals will be different. Taking Beijing as an example, the reimbursement standard of social security outpatient service is: outpatient treatment items that meet the requirements, outpatient invoices, prescriptions, inspection reports and other supporting documents that meet the conditions of overall payment issued by doctors, and the self-funded part exceeds that of 500 yuan, the overall fund shall be reimbursed according to 60% of the actual burden of local insured residents, and the maximum reimbursement amount shall not exceed that of 500 yuan. That is to say, the portion exceeding 500 yuan will be reimbursed at the rate of 60%, but the maximum reimbursement amount can only reach 500 yuan. It should be noted that there are other restrictions on social security outpatient reimbursement, such as drug list and medical expenses. For details, please refer to the regulations of the local medical insurance department.
Can social security outpatient reimbursement be collected when seeing a doctor? Under normal circumstances, you can not accept reimbursement from social security clinics during treatment. After seeing a doctor, you need to submit invoices, prescriptions and other related documents to the financial department or social security department of the hospital for reimbursement accounting. Some hospitals have also opened convenient operation methods such as self-service reimbursement machines to facilitate residents' reimbursement. However, it is necessary to pay attention to the accuracy and completeness of the information in the operation so as not to affect the reimbursement.
Social security outpatient expenses can be reimbursed, but the amount and proportion of reimbursement in different regions and hospitals are different, which needs to be determined according to the specific situation. At the same time, we also need to pay attention to various regulations and requirements in order to successfully complete the reimbursement application.
Legal basis:
"People's Republic of China (PRC) Social Insurance Law" Article 23 * * * employees shall participate in the basic medical insurance for employees, and employers and employees shall pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
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