Legal analysis: local medical insurance card can only be used within the local area.
The main reimbursement scope of Yunnan medical insurance card includes medicines, sterilized products, health care products and medical devices.
1, all "State Drug Approval Number" drugs (including medicines outside the medical insurance drug catalog), all units or compounded Chinese herbal medicines and medicinal materials;
2, "Wei-Fei Jin-zhu", "Wei-Fei Quasi", "" Wei Fanshi "," Wei Fanshi certificate number "disinfection supplies;
3," National Food and Drug Administration ", "Guardian food and health care" health care products;
4, "food and drug supervision and mechanical (into) size", "food and drug supervision and mechanical (quasi) size", Examination and treatment programs using PET, CT, and ophthalmic excimer laser therapy equipment. Orthopedic myopia, dental cleaning, spectacles with therapeutic or preventive effect, denture, eye prosthesis, prosthetic limbs.
6. The medical insurance card can pay for the medical expenses of oneself and one's immediate family members
a. Individual contributions to urban workers' major illness supplemental medical insurance premiums;
b. Contributions to the basic medical insurance and major illness supplemental medical insurance premiums for flexibly employed persons participating in urban workers' basic medical insurance;
c. Purchase of commercial supplemental medical insurance premiums;
d. Immediate relatives hospitalized in the designated medical institutions should be paid for.
e. Immediate family members' vaccination fees incurred at designated medical institutions.
Of these, items 1-4 belong to the scope of payment of medical insurance participants can use their medical insurance cards to purchase at designated retail pharmacies or hospitals. Item 5 is mainly used in designated medical institutions.
Outpatient reimbursement scope
1, outpatient special examination: Yunnan Province provides for 26 special examination items such as magnetic *** vibration, CT, color ultrasound, etc., with 70% reimbursement by the coordinated fund and 30% borne by individuals.
2. Outpatient emergency resuscitation: medical fees for outpatient emergency resuscitation (including 120 emergency vehicles) are reimbursed according to the hospitalization treatment.
Legal basis: The Social Insurance Law of the People's Republic of China
Article 30 The following medical expenses shall not be included in the scope of payment by the basic medical insurance fund:
(1) Those that should be paid from the Industrial Injury Insurance Fund;
(2) Those that should be borne by a third party;
(3) Those that should be borne by the public ****health;
(iv) if the medical treatment is outside the country.
Medical expenses shall be borne by a third person in accordance with the law, and if the third person fails to pay or if the third person cannot be identified, the basic medical insurance fund shall pay in advance. The basic medical insurance fund shall have the right to recover the costs from the third party after the payment is made.
Article 31 The social insurance administration organization may, according to the needs of management and service, sign service agreements with medical institutions and drug business units to regulate the behavior of medical service. Cited in 2 cases
Medical institutions shall provide reasonable and necessary medical services to insured persons.
Article 32 If an individual is employed across the integrated region, his basic medical insurance relationship shall be transferred with him, and the years of contribution shall be cumulative.