Detailed steps of employee medical insurance reimbursement:
1. medical treatment: when employees need medical treatment, they should first choose cooperative medical institutions or doctors for medical treatment. Ensure that medical institutions or doctors have a cooperative relationship with the medical insurance institutions where employees are located.
2. Medical insurance card: employees need to carry personal medical insurance cards when seeking medical treatment. The medical insurance card is an employee's identity certificate and an important voucher for reimbursement.
3. Medical registration: employees need to register for medical treatment after arriving at medical institutions. In the registration process, you need to provide personal basic information, medical insurance card number, etc.
4. Settlement of medical expenses: After seeing a doctor, the medical institution makes settlement according to the actual medical expenses. Employees need to pay their own expenses, and medical institutions will provide a list of expenses.
5. Preparation of reimbursement materials: Employees need to prepare relevant reimbursement materials, including medical expense lists, invoices, medical certificates, personal identification certificates, etc. Ensure the authenticity and integrity of these materials.
6. Reimbursement application: After employees prepare the reimbursement materials, they need to submit the reimbursement application to the local medical insurance institution. In the application process, it may be necessary to fill in some forms and provide relevant supporting materials.
7. Examination and approval: The medical insurance institution examines the application for reimbursement. They will check the authenticity of the reimbursement materials and approve them according to the policy.
8. Reimbursement payment: Once the reimbursement application is approved, the medical insurance institution will transfer the reimbursement to the bank account designated by the employee. Employees can get reimbursement through bank cards or other means.
Employee medical insurance reimbursement application materials and matters needing attention list refers to the materials and matters needing attention list when employees apply for medical insurance reimbursement. According to different medical insurance policies, applicants need to provide relevant personal identification, medical expense invoices, medical certificates, medical records and other materials. At the same time, we also need to pay attention to the time limit, application process, reimbursement ratio and other matters.
To sum up, preparing a complete list of materials and observing precautions can improve the success rate of applying for medical insurance reimbursement and ensure that employees can enjoy the medical expenses reimbursement they deserve. In order to successfully apply for medical insurance reimbursement, employees should know the specific requirements of their region in advance so as to prepare relevant materials as required.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
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.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.