First, the reimbursement method of hospitalization medical insurance
(1) On-site online settlement
At present, most hospitals can settle accounts online. Inpatients only need to carry their ID cards and medical insurance cards, go through the relevant formalities at the admission office, and settle accounts directly when they leave the hospital. Patients only need to pay the remaining hospitalization expenses. For example, hospitalization costs 5,000 yuan, reimbursement costs 3,000 yuan, and patients only need to pay 2,000 yuan. This reimbursement is relatively simple.
(2) Off-site online settlement
For hospitals that cannot make on-site online settlement, patients need to bring:
1, hospitalization invoice (hospital seal)
2, hospitalization expenses details (hospital seal)
3, diagnosis certificate (hospital seal)
4, discharge summary (hospital seal)
5, medical records (hospital seal)
6, some areas need information confirmation or referral form (doctor's signature, hospital seal).
After discharge, bring the above information to the insured place for reimbursement.
Two, the basic insurance will not pay the cost of the scope of the diagnosis and treatment project.
(1) service items
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for name calling operation, high quality and good price, and special care by oneself.
(2) Non-disease treatment projects
1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;
2, a variety of weight loss, weight gain, increase the project.
3. Various health checks.
4, all kinds of prevention and health care projects.
5, tooth deformity, tooth porcelain.
6, all kinds of medical consultation (excluding psychiatric consultation), medical appraisal.
(3) Diagnostic equipment and medical materials.
1, a project for examination and treatment with large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus.
2, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment.
3, all kinds of self-use health care, massage, rehabilitation and treatment equipment.
(4) Treatment items
1, the organ source or tissue source of various organ transplants or tissue transplants;
2. Transplantation of organs or tissues other than kidneys, heart valves, corneas, skin, blood vessels, bones and bone marrow.
3. Orthopedic surgery for myopia
4, Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) Others
1, various infertility (pregnancy), sexual dysfunction diagnosis and treatment projects
2, all kinds of scientific research, clinical verification of diagnosis and treatment projects.
The above is the relevant information compiled for everyone. Expense-based medical insurance is to pay insurance money according to the actual medical expenses incurred by customers and the insurance amount agreed in the policy, in order to compensate customers for medical expenses. When making a claim, the customer needs to issue an invoice for outpatient service or hospitalization.