Six kinds of medical expenses are not included in the basic medical insurance fund payment scope:
1. Medical expenses exceeding the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards;
2 should be paid from the industrial injury insurance fund;
3. Should be borne by a third person;
4. Should be borne by public health;
5. Go abroad for medical treatment;
6. Other non-payment fees stipulated by the state and the autonomous region.
Maximum reimbursement of medical insurance
In a medical year, the overall fund will compensate the insured for hospitalization expenses and outpatient medical expenses for chronic diseases that do not exceed the maximum payment limit of 250,000 yuan. If necessary, the relevant departments can adjust the maximum payment limit according to the regulations.
Materials required for reimbursement of medical insurance in Inner Mongolia
1, hospital invoice (seal)
2. Detailed list of hospitalization expenses (seal)
3. Discharge record (seal)
4, the use of drugs outside the directory and special diagnosis and treatment project copy (seal)
5. Medical insurance card
Legal basis:
People's Republic of China (PRC) social insurance law
Article 73 Social insurance agencies shall establish and improve business, financial, safety and risk management systems. Social insurance agencies shall pay social insurance benefits in full and on time. ;
Article 8 of the Social Insurance Law of People's Republic of China (PRC) provides social insurance services and is responsible for social insurance registration, personal rights and interests record and social insurance benefits payment.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.