First of all, the insured person needs to seek medical treatment in a designated medical institution and register for medical treatment with a social security card or medical insurance electronic certificate. In the process of medical treatment, the insured person should be treated according to the prescription or check the treatment documents issued by the doctor.
Secondly, after the treatment, the insured person needs to carry relevant documents (such as social security card, medical insurance electronic certificate, prescription, inspection and treatment documents, etc.). ) go to the medical insurance window for settlement and reimbursement. The medical insurance window will review the medical expenses of the insured according to the medical insurance policy and calculate the amount that should be reimbursed. Finally, the insured person can receive the reimbursement amount in the medical insurance window, or he can choose to directly credit the reimbursement amount into the personal medical insurance account. It should be noted that the calculation and payment of reimbursement amount should follow the relevant provisions of medical insurance policy, such as minimum payment standard and reimbursement ratio.
Medical insurance reimbursement methods are as follows:
1. Before seeing a doctor: Before seeing a doctor, you need to confirm the type and scope of your medical insurance, choose medical institutions and doctors that meet the medical insurance policy, and ensure that medical expenses can be reimbursed;
2. During medical treatment: during medical treatment, you need to fill in your basic personal information and medical conditions accurately, and provide your medical insurance card and related certification materials to doctors and medical institutions;
3. Reimbursement application: After seeing a doctor, you need to submit an application for reimbursement of medical expenses to the local social insurance management center or medical insurance office, and provide relevant medical expenses bills and supporting materials, such as outpatient invoices, prescription notes, medical records, etc.
4. Reimbursement review: medical insurance institutions review the application for reimbursement of medical expenses, check the information such as expenses and illness, and determine the proportion and amount of reimbursement;
5. Reimbursement payment: After approval, the medical insurance institution will pay the reimbursement amount to the applicant's bank account or medical insurance card.
To sum up, it is recommended that the insured carefully understand the latest medical insurance policy before reimbursement to ensure that they can enjoy medical insurance benefits smoothly. At the same time, you can also consult the medical insurance service window or call the medical insurance service hotline to get more detailed and accurate reimbursement guidance.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 23
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.