As we all know, the treatment costs required for serious accidental injuries are quite a lot, in order to alleviate the burden on people and provide them with appropriate accidental protection, accidental medical insurance appeared. I hope it will be helpful to everyone.
Accidental medical insurance should be how to reimbursement
1, after the accident, you need to promptly notify the insurance company to report the accident, and will inform the insurance company of the relevant details of the accident, including the time, place, after the content.
2. In the process of handling the accident, the insured needs to collect and prepare the appropriate reimbursement information, and then submit the reimbursement application and reimbursement information to the insurance company to apply for reimbursement.
3. The insurance company reviews the information submitted by the applicant, and after passing the review, the insurance company will pay the reimbursement amount to the corresponding bank card of the insured.
Generally, accidental medical insurance exists as an add-on to accidental insurance, which compensates for medical expenses caused by accidents. To apply for reimbursement of accidental medical insurance, you need to notify the insurance company first, then submit the reimbursement information, and the insurance company will get the insurance benefit after reviewing and approving without any problem. During the reimbursement process, the applicant needs to provide the application form, insurance policy, proof of identity of the insured, accident certificate from the relevant authorities, original medical bills, hospital diagnosis certificate, medical expenses schedule, and in case of death of the insured, the death certificate and a series of other reimbursement documents to ensure that the reimbursement can be passed smoothly.
Second, how to determine the reimbursement rate of medical insurance
The reimbursement rate of medical insurance is based on the level of the hospital.
1, the hospital charges of the three hospitals starting point is 200. medical insurance reimbursement rate is 85 percent.
2. The starting point of the hospital fee for a category 2 hospital is 400, and the reimbursement rate for health insurance is 70 percent.
3. The starting point of the fee for the first category of hospitals is 600, and the reimbursement rate for the health insurance is 60 percent.
Three, medical insurance deductible items what
1, service category. The cost of the registration fee, the cost of medical records. Consultation fee, consultation fee (including home bed rounds fee), examination and treatment expedited fee, name surgery surcharge, quality premium fee, escort fee, self-requested special nurse fee and other special service costs.
2. Non-disease treatment programs. A variety of beauty, fitness programs and some non-functional cosmetic and orthopedic surgery costs. Various weight loss, weight gain, height increase programs. Various health checkups. Various preventive and health care treatment programs. All kinds of medical consultation, medical appraisal program.
3, medical materials. Spectacles, denture, eye prosthesis, prosthetics, hearing aids and other rehabilitative devices. A variety of self-use health care, massage, inspection and treatment equipment. Buried automatic defibrillator (ICD). Provincial and municipal price department regulations can not be charged separately disposable medical materials.
3, diagnostic and therapeutic equipment. Application of positron emission tomography device (PET), electron beam CT, ophthalmic excimer laser treatment device and other large medical equipment for examination and treatment programs.
4, treatment program category. Various types of organ or tissue transplantation organ source or tissue source. Other organ transplants or tissue transplants except kidney, heart valve, cornea, skin, blood vessel, bone and bone marrow transplants. Orthopedic surgery for myopic eyes. Complementary therapeutic programs such as qigong therapy, music therapy (except for psychiatric patients), health nutritional therapy, and magnetic therapy.
5. Other. Various infertility (fertility), sexual dysfunction diagnosis and treatment programs. A variety of scientific research, clinical verification of the diagnosis and treatment program. Due to fighting, assault, alcoholism, traffic accidents, medical malpractice, injury liability accidents, intentional self-injury and self-inflicted injuries incurred all the costs. Medical expenses incurred while going abroad and visiting relatives in Hong Kong, Macao and Taiwan, meetings, study tours, further training and lectures. Except for emergency and first aid, the medical treatment items conducted by the designated medical institution are beyond the scope of the registered medical treatment subjects. Diagnostic and therapeutic programs of the designated medical institution in cooperation with foreign countries. Diagnostic and therapeutic items that are not included in the medical service charge standards stipulated by the provincial and municipal price departments.
The above is the whole content of this article, I hope it can help you, can give you answers to the questions in your mind. They are online 24 hours a day and can answer your legal doubts at any time.
Legal Objective:Social Insurance Law
Article 28
Medical expenses in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as emergency and rescue, shall be paid from the basic medical insurance fund in accordance with state regulations.
Social Insurance Law
Article 29
The portion of the medical expenses of insured persons that should be paid out of the basic medical insurance fund shall be settled directly by the social insurance administration agencies with the medical institutions and 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.