How to reimburse children's hospitalization expenses for medical insurance

The medical insurance reimbursement process for children's hospitalization expenses is as follows:

1. The premise of hospitalization medical insurance reimbursement is that the insured can only be reimbursed if he has an insurance accident during the insurance period and needs treatment;

2. When reimbursing, parents should submit the hospitalization medical insurance contract, medical insurance card, hospitalization settlement voucher, hospitalization invoice, medical record copy, medical insurance catalogue and payment bill to the hospital in time for medical staff to check reimbursement;

3. The reimbursement rate of children's hospitalization medical insurance is generally high, among which the reimbursement rate of outpatient expenses is about 50% and the reimbursement rate of hospitalization expenses is above 60%;

4. When reimbursing, you usually need to pay the medical expenses yourself before you can reimburse.

Children's medical insurance reimbursement materials:

1, medical insurance card: children's medical insurance card is required to prove that they have been insured;

2. Medical treatment certificate: it is necessary to provide the child's medical records and medical expense invoices and other relevant documents to prove that the child has indeed provided relevant medical services and paid relevant expenses;

3. Proof of identity: the child's valid identity document, household registration book and other documents are required to prove his identity and legitimacy;

4. Treatment plan: it is necessary to provide documents such as treatment plan and diagnosis certificate issued by the hospital to prove the child's disease diagnosis and treatment plan;

5. Other materials: If necessary, other relevant materials such as hospitalization deposit certificate and outpatient registration certificate shall be provided.

To sum up, different regions and types of medical insurance may have different procedures and requirements for reimbursement of children's medical insurance, and the specific requirements need to be operated according to local policies and regulations.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

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.