1, work-related injuries medical reimbursement
Employees in the work-related injuries, the medical expenses incurred by the work-related injuries, with the conclusion of the work-related injuries, a copy of the discharge summary (including: date of entry and exit from the hospital, the main complaint of the hospital, the current medical history, examination, diagnosis, treatment, surgery, treatment and return to the situation, and the discharge notes. Stamped with the seal of the hospital), a detailed list of medical expenses (including: the name, dosage, number of times, unit price, and total price of each item of medication, examination, treatment, surgery, and laboratory test), and a valid reimbursement receipt (with a seal supervised by the financial department or a seal supervised by the tax department and the hospital's fee stamp), the unit will apply for reimbursement at the health insurance agency (Audit Department).
2, individual medical expenses reimbursement
The scope of reimbursement of individual medical expenses for injured workers: has been filed for the record of personnel stationed abroad, settled in a different place of injured workers in their own choice of filing the agreement on the cost of treatment of work-related injuries in the medical institutions; approved by the medical institutions outside of the agreement on the cost of medical treatment; the injured worker to visit their relatives in the country or in the field of treatment of the recurrence of old injuries (can only be in the nonprofit medical institutions) costs. The cost of visiting relatives or treating the recurrence of old injuries abroad (only in non-profit medical institutions); the cost of emergency treatment and first aid due to work-related injuries during business trips.
The reimbursement of individual medical expenses must be submitted to the following information: referral and transfer approval procedures, the participating units of the family visit, business trip certificate or certificate of the relevant hospitals, discharge summary (including: the date of entry and exit from the hospital, admission complaints, the history of the current medical condition, examination, diagnosis, treatment, surgery, treatment and return to the situation, and discharge notes. Stamped with the seal of the hospital), a detailed list of medical expenses (including: the name, dosage, number of times, unit price, and total price of each item of medication, examination, treatment, surgery, and laboratory tests), and a valid reimbursement document (with the seal supervised by the financial department or the seal supervised by the tax department and the special seal for the hospital charges), and then apply for reimbursement by the unit at the health insurance agency (Audit Department).
Workers suffered work-related injuries, in the recognition of work-related injuries, work-related injuries disability rating, you can rely on the identification of the disability rating to the Work Injury Insurance Fund to make a claim, at the same time, in the treatment of work-related injuries or rehabilitation period can also ask the employer to leave their jobs without pay, the unit in the statutory period of leave without pay, shall not be deducted from the employee's original salary entitlements for no reason.
Legal basis:
According to the "People's Republic of China*** and the State of urban workers' basic medical insurance regulations"
Article 31 of the basic medical insurance fund to pay part of the cost of diagnostic and therapeutic items and drugs of the Class B directory, and the proportion of the individual out-of-pocket payment, shall be determined by the people's government of the province.
Article 32 The medical expenses for Category A infectious diseases such as cholera and plague shall be fully paid by the integrated fund. Medical expenses for outbreaks and epidemics of infectious diseases recognized by the administrative department of health shall be settled by the people's government through the allocation of special funds.
Article 33 State civil servants and other persons who meet the requirements shall, on the basis of their participation in basic medical insurance, be given medical subsidies. In order to solve the problem of medical expenses above the maximum payment limit for persons other than those stipulated in the preceding paragraph, the provincial people's government may organize and implement supplementary medical insurance.