Job Recruitment Website - Social security inquiry - Can I get reimbursed by my health insurance for being hospitalized in a car accident?
Can I get reimbursed by my health insurance for being hospitalized in a car accident?
Can be reimbursed.
Medical management: If the unit pays in full, the individual only needs to pay part of the hospitalization advance payment, you can go through the hospitalization procedures. The medical expenses incurred should be in line with the scope of the three major directories of medical insurance;
Reimbursement process: the hospital and the individual to settle the amount of out-of-pocket expenses and self-assumption when discharged from the hospital, the amount of reimbursement of the integrated fund by the hospital and the district health insurance center settlement.
Reimbursement scope: medicine: auxiliary examination: EKG, X-ray fluoroscopy, filming, laboratory tests, physiotherapy, acupuncture, CT, nuclear magnetic **** vibration and other various examination fees limit of 200 yuan; surgical fees (with reference to the national standard, more than 1,000 yuan reimbursement of 1,000 yuan). 60 years of age or older hospitalized in a health center, the treatment costs and nursing care costs of compensation of 10 yuan per day, a limit of 200 yuan.
Reimbursement rates:Township health centers reimburse 60%; secondary hospitals reimburse 40%; tertiary hospitals reimburse 30%.
Major Diseases
Any hospitalized patient who participates in cooperative medical care and whose one-time or yearly cumulative reportable medical expenses exceed 5,000 yuan is compensated in segments, i.e., 5,001-10,000 yuan is reimbursed at 65%, and 10,001-18,000 yuan is reimbursed at 70%. The annual limit of compensation for inpatient hospitalization and outpatient blood dialysis for uremia, outpatient radiotherapy and chemotherapy for tumors is 11,000 yuan at the township level cooperative medical treatment.
Exemptions
Self-medical treatment (without designated hospitals for medical treatment or without referral orders), self-purchased medicines, medicines that cannot be reimbursed under the public medical care regulations and medical expenses not in line with family planning; outpatient treatment fees, consultation fees, hospitalization fees, meals, companion fees, nutritional fees, blood transfusion fees (except for those who have family blood storage, which is reimbursed in accordance with the relevant regulations), heating and cold air, ambulance fees, special Other expenses such as nursing care; medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice; orthopedic, cosmetic, dental, prosthetic, organ transplantation, named surgery, consultation fees, etc.; reimbursement within the scope of reimbursement, but not outside the limit.
Specific reference to social security reimbursement
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