After medical insurance hospitalization, the hospital bed fee can be reimbursed according to the prescribed amount, and the general bed fee in tertiary hospitals is basically within the prescribed amount. However, there will be a certain percentage of bed fees for advanced beds or private beds that exceed the regulations at their own expense.
Medical insurance reimbursement scope:
1, the difference between medical insurance drugs and non-medical insurance drugs, and the reimbursement deductible line are also different according to the hospital level. Generally, Class A drugs can enjoy full coverage, while Class C drugs need to bear all the expenses, while Class B drugs will be charged 80% and bear 20% of the expenses.
2, the designated medical institutions every month 10, will be discharged last month's list of expenses, hospitalization list and related information submitted to the medical insurance agencies, medical insurance agencies after the audit, as a basis for monthly pre-allocation and year-end accounts. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month.
Extended data:
The following are not included in the scope of reimbursement of rural cooperative medical insurance:
1. Medical treatment at one's own expense (no designated hospital or referral form), drugs purchased at one's own expense, drugs that cannot be reimbursed according to the regulations of public medical care and medical expenses that do not meet the requirements of family planning;
2, outpatient treatment fees, visits, hospitalization fees, meals, escort fees, nutrition fees, blood transfusion fees (except for family blood storage, according to the relevant provisions of reimbursement), heating and cooling fees, ambulance fees, allowances and other expenses;
3. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents;
4. Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc. ;
5, within the scope of reimbursement, beyond the limit.
Many farmers have bought some commercial medical insurance after purchasing the new rural cooperative medical system. If you buy commercial medical insurance, you must first reimburse the expenses of the new rural cooperative medical system, and then find an insurance company to reimburse the remaining expenses.
Baidu encyclopedia-medical insurance reimbursement scope