1. Class A medical insurance: Class A medical insurance is the highest grade of medical insurance, which is generally provided by institutions and state organizations and other units. Within the scope of Class A medical insurance, most of the medical expenses can be reimbursed, and the reimbursement rate is generally above 80%;
2. Class B medical insurance: Class B medical insurance is the middle grade of medical insurance, generally provided by enterprises and urban residents. The reimbursement rate within the scope of Class B health insurance is generally around 70%, and some provinces will also set different reimbursement rates according to different medical expense items;
3. Class C health insurance: Class C health insurance is the lowest grade of basic medical insurance, generally provided by farmers and urban and rural residents, etc. The reimbursement rate of Class C health insurance is about 80%. The reimbursement rate is generally around 50% within the scope of Class C medical insurance;
4. Class D medical insurance: Class D medical insurance is special medical insurance, generally provided by specific occupational groups. Within the scope of Category D health insurance, the reimbursement rate varies by specific health insurance regulations, and may also set different reimbursement rates for different medical expense items.
Methods of reimbursement are as follows:
1. Before seeking medical treatment: Before seeking medical treatment, you need to confirm the type and scope of your own medical insurance, and choose a medical institution and doctor in line with the medical insurance policy to ensure that your medical expenses will be reimbursed;
2. During the process of seeking medical treatment: During the process of seeking medical treatment, you need to fill in the basic information of your personal information and medical treatment accurately, and provide your medical card and relevant information to the doctor and medical institution. Provide doctors and medical institutions with their health insurance cards and relevant supporting materials;
3. Reimbursement application: After the end of the medical treatment, you need to submit the application for reimbursement of medical expenses to the local social insurance management center or medical insurance office, and provide relevant medical bills and supporting materials, such as outpatient invoices, prescription pads, medical records, etc.
4. Reimbursement review: medical insurance institutions review and verify the medical expenses and reimbursement of medical expenses, and then reimburse the medical expenses. The medical insurance organization reviews the application for reimbursement of medical expenses and checks information such as expenses and medical conditions to determine the reimbursement rate and amount;
5. Reimbursement Payment: After the review is approved, the medical insurance organization pays the reimbursement amount to the applicant's bank account or medical insurance card.
In summary, the reimbursement methods may vary in different regions and types of health insurance, and the specific reimbursement process needs to be operated according to local policies and regulations. In addition, when making reimbursement, you need to carefully check your health insurance information and medical expenses to avoid filling in incorrect or false information, so as not to affect the efficiency and accuracy of reimbursement.
Legal basis:
Article 23 of the Social Insurance Law of the People's Republic of China
Employees shall participate in the basic medical insurance for employees, and shall pay the basic medical insurance premiums by the employing unit and the employees in accordance with the state regulations***. Individual industrial and commercial households without employees, part-time workers who do not participate in the basic medical insurance for employees in their employing units, and other flexibly employed persons may participate in the basic medical insurance for employees, and individuals shall pay the basic medical insurance premiums in accordance with the State regulations.
Article 28
Medical expenses that conform to the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergencies and rescues, shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 29
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.