Among patients with fever, the medical expenses incurred during the outpatient investigation can be continuously included in the reimbursement of hospitalization expenses, and the confirmed and suspected personnel determined according to the COVID-19 diagnosis and treatment plan of the health department can enjoy free medical treatment; If it cannot be recorded in the hospitalization expenses continuously, it can be paid in advance by the hospital, and will be liquidated after the epidemic is over.
The medical expenses incurred during the outpatient investigation of other fever patients shall be paid by the patients themselves.
Pay attention to medical treatment and drug purchase in designated institutions.
There are medical insurance designated institutions! When participating in insurance, you must remember where your designated hospital is, and you can only be reimbursed if you go to a designated hospital for medical treatment; If you go to a non-designated medical institution, there is no way to reimburse the treatment expenses, and you can only bear it yourself. The same is true for buying medicine. Only designated pharmacies with medical insurance can swipe their medical insurance cards to buy medicines, and other pharmacies can only pay their own money.
Don't transfer without permission.
Some diseases can't be seen in designated medical institutions. If you want to go to a better hospital for treatment, you must first apply for referral, and the referral with complete procedures can be reimbursed; If you don't apply for referral, it is still equivalent to going to a designated medical institution that you have no choice, and you still can't reimburse. There is often a gap in the reimbursement ratio. Generally speaking, the higher the level of hospital treatment, the lower the reimbursement rate.
You can only apply for medical insurance if the deductible line crosses the line.
Medical insurance has a deductible, and you can only reimburse it if you pay that amount first. For example, X stipulates that the outpatient deductible line is 1.800 yuan, and if the total amount of outpatient medical treatment in one year is less than 1.800 yuan, all the money must be paid by yourself; And if it exceeds 1800 yuan, it can be reimbursed. At the same time, medical insurance also has a cap line, which means that medical insurance can give you the most money, and the excess money cannot be reimbursed.
Some drugs cannot be reimbursed.
The drugs reimbursed by medical insurance are specific, and only drugs in the medical insurance catalogue can be reimbursed, but drugs outside the medical insurance catalogue cannot be reimbursed, such as many expensive imported innovative drugs and patented drugs. So communicate with the doctor before taking medicine. If you want to save money, use the medicine in the catalogue.
Some special surcharges cannot be reimbursed.
It is common to be hospitalized in your private room or to ask for special services, such as specialized doctors and nurses. These are not reimbursable. If you really have special needs, pay for it yourself.
Pay attention to the time limit for reimbursement.
Social security card must be used to settle all kinds of expenses when leaving the hospital. Special circumstances can not be settled in real time, you can take documents and vouchers to the medical insurance department for manual reimbursement of medical expenses in the future. But we must hurry up at this time, because there is often a time limit. For example, some local medical insurance departments will conduct liquidation before the end of the year, and they will not be reimbursed after the deadline. Don't forget to reimburse the medical expenses because of carelessness. You can only bear these expenses yourself after the deadline.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
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.