1, the insured person will prescribe medicine at the designated medical insurance hospital, and if the hospital has an inpatient department at the same time, the insured person will prescribe medicine at the inpatient department;
2. When prescribing drugs, you need to bring your social security card or use the medical insurance electronic certificate for settlement;
3. Not all medical insurance expenses can be reimbursed, such as the following medical expenses: self-seeking, self-purchasing drugs, drugs that cannot be reimbursed according to public medical regulations, and medical expenses that do not meet family planning; Nursing expenses, ambulance expenses, escort expenses, nutrition expenses, blood transfusion expenses, cooling and heating expenses, myopia correction expenses, etc. ; New medical services during outpatient treatment (or hospitalization); Beauty, bodybuilding, non-functional cosmetic surgery, orthopedic surgery, various weight loss, weight gain and height increase projects; All kinds of medical consultation (including growth and development, genetic eugenics consultation) and physical examination items; Various preventive health care and nutritional drugs (especially for pregnant women) and treatment and rehabilitation projects for dyskinesia diseases specified in the scope of basic medical insurance diagnosis and treatment projects.
Medical insurance reimbursement conditions:
1. Confirm the insured status: before seeking medical treatment, you need to confirm that you have participated in local medical insurance, which can be confirmed by means of social security card and medical insurance certificate;
2. Medical category: Medical insurance generally only reimburses therapeutic medical behaviors, such as outpatient service, hospitalization, surgery and examination. Some cosmetic medical behaviors, such as dental beauty and plastic surgery, are usually not covered by medical insurance reimbursement;
3. Medical expenses: Medical insurance will only reimburse medical expenses that meet the requirements, such as medical expenses, medicine expenses, examination expenses, operation expenses, etc. Personal expenses, medical insurance will not be reimbursed;
4. Hospital qualification: Medical insurance will only reimburse the medical expenses of legally operated medical institutions, such as public hospitals and qualified private hospitals. Medical insurance will not be reimbursed for illegal medical institutions or clinics.
To sum up, the specific reimbursement ratio and policies may vary by region and time. You can consult the local medical insurance department or the medical insurance Commissioner of the hospital.
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.