The first co-payment of Category B refers to the fact that after the medical insurance fund pays part of the cost, the remaining cost is borne by the individual, but can be reimbursed by the medical insurance. Specifically, Category B drugs or treatment items require individuals to pay a certain percentage of the cost first, called the "first out-of-pocket", generally ranging from 5% to 20%, and then the remaining costs will be reimbursed by the medical insurance fund in accordance with the proportion.
Materials for medical insurance reimbursement:
1, medical insurance card: a valid medical insurance card;
2, medical records: need to provide medical records, including the department, date of consultation, diagnosis, treatment plan, etc.;
3, prescription paper: need to provide the original prescription paper and a copy of the paper, including the name of the drug, dosage, usage, use, and other information.
4, receipts: you need to provide the original and copies of receipts for the purchase of drugs or treatment costs, including the name of the drug, the number of unit price, the amount of money and other information;
5, hospitalization records: if you are hospitalized, you need to provide inpatient hospital records, discharge summary and other hospitalization records;
6, other related materials: such as the outpatient medical expenses settlement statement, the inpatient medical expenses settlement statement, hospital-issued inspection reports, laboratory reports, etc..
In summary, the process of medical insurance reimbursement may be slightly different in different regions, and the specific operation steps can be adjusted according to the local policy regulations and actual situation.
Legal basis:
Article 2 of the Social Insurance Law of the People's Republic of China
The State establishes a social insurance system for basic pension insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., and guarantees the right of citizens to obtain material assistance from the State and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment and maternity.
Article 3
The social insurance system adheres to the policy of broad coverage, basic protection, multi-level and sustainability, and the level of social insurance shall be commensurate with the level of economic and social development.
Article 4
Employing units and individuals within the territory of the People's Republic of China*** and the State pay social insurance premiums in accordance with the law, and have the right to inquire about the records of payment of premiums and the records of individual rights and interests, and to request that the social insurance administration agencies provide social insurance counseling and other related services.
Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise the payment of contributions for them by their own units.