Yes, outpatient medical examination fees can be reimbursed by the medical insurance. If it is in a designated medical institution, it can be reimbursed, usually when the card is swiped directly from the medical insurance fund to pay a part of it; if it is not a designated place can not be reimbursed. According to the basic requirements of China's basic medical insurance benefits payment, participants to the medical insurance organization to reimburse their medical expenses incurred to see a doctor need to go to the medical insurance designated medical institutions.
Outpatient examination fee medical insurance reimbursement, different cities have different requirements, some cities do not support the medical insurance outpatient reimbursement, but some cities can be reimbursed, such as outpatient reimbursement in Beijing, you need to exceed the starting line of 1,800 yuan, can be reimbursed, the annual limit of 20,000, like Shanghai, you need to exceed the starting line of 1,500 yuan, reimbursement rate of 50-75%, Guangzhou reimbursement rate of 45%-80%, limit of 300 yuan per month, reimbursement rate is 45%-80%, limit is 300 yuan. 80%, and the limit is 300 yuan/month.
Additionally, outpatient reimbursement rates are different for different levels of hospitals, with a higher reimbursement rate and a lower starting line for first-tier hospitals. For people with chronic diseases who need to take medication for a long time, they can also be reimbursed through the health insurance, which mainly refers to outpatient chronic diseases and outpatient special diseases, and the reimbursement rate for such medications is 50%-90% as long as they are in the health insurance catalog.
If the employee health insurance, and is divided into individual account and integrated account, the individual account is usually in the outpatient clinic to see a doctor, you can use the balance of the individual account to pay by credit card. The coordinated account refers to the money that is not usually allocated to the personal account, handed over to the state unified domination, mainly used for medical reimbursement.
What are the items included in the reimbursement of medical insurance
The reimbursement of medical insurance is categorized as well as the items included as follows:
1, general medical insurance. It mainly includes outpatient costs, medical costs, examination costs and so on.
2. Hospitalization insurance. It mainly covers daily hospitalization fee, cost of utilizing hospital equipment, surgery cost, medicine cost and so on.
3. Surgical insurance. Provides for all expenses incurred due to necessary surgery required by the patient.
4. Comprehensive medical insurance. Its cost coverage includes all costs of medical treatment and hospitalization and surgery, etc.
5, special disease insurance. Certain special diseases often bring the patient a catastrophic cost payment, the average resident family can hardly afford. Examples include cancer and heart disease. Provide coverage for policyholders of major diseases, can be a single, such as malignant tumors, or even malignant tumors in a certain number of cancers.
I hope the above can help you, if you have other questions please consult a professional lawyer.
Legal basis: "Chinese People's **** and State Social Insurance Law"
Article 29
The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administration organization with the medical institutions and the drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.