Children’s phimosis surgery can be reimbursed by medical insurance. If the child is covered by relevant medical insurance, he can also apply for compensation from the insurance company. The insurance company will immediately underwrite the claim after receiving the claim application, and the underwriting will be approved. The compensation funds will then be credited to the policyholder's account. Phimosis in children is a plastic surgery and cannot be reimbursed. Only commercial insurance can reimburse it.

Scope of use of medical insurance cards

1. Outpatient and emergency medical expenses

1. For current employees, after going to the hospital’s outpatient clinic or emergency room for medical treatment, medical expenses exceeding 1,800 yuan Only expenses can be reimbursed, and the reimbursement rate is 50%.

2. Retirees under the age of 70 can be reimbursed for expenses exceeding 1,300 yuan, and the reimbursement rate is 70%.

3. For retirees over 70 years old, 80% of expenses above 1,300 yuan can be reimbursed.

2. Hospitalization expenses The maximum payment amount of the basic medical insurance pooling fund (hospitalization expenses) in one year is currently 70,000 yuan.

1. The standard of hospitalization reimbursement is related to the level of the hospital where the insured person lives. If the insured person lives in a third-level hospital, the employee pays 15% of the cost from the minimum payment standard to 30,000 yuan, that is, 85% is reimbursed;

2. Employees pay 10% of the expenses from 30,000 yuan to 40,000 yuan, and 90% is reimbursed;

3. The portion exceeding 40,000 yuan up to the maximum payment limit 95% of the expenses can be reimbursed, and employees only need to pay 5%.

4. The proportion of personal payment for retirees is 60% of that of active (the above-mentioned) employees, but anything below the minimum payment standard is paid by the individual.

3. Designated hospitals and designated retail pharmacies Reimbursement scope of designated hospitals and designated retail pharmacies: Insured persons must go to 4 designated medical institutions of their choice for personal medical treatment (except for emergencies), or designated traditional Chinese medicine doctors, Only medical treatment in specialists (including dental hospitals, obstetrics and gynecology hospitals, oncology hospitals, etc.) and 11 Class A medical institutions can be reimbursed.

Legal basis:

"Regulations of the People's Republic of China on Basic Medical Insurance for Urban Employees"

Article 28 Personal accounts are used for payment coordination Medical expenses beyond the scope of fund payment; if the personal account is insufficient to pay, it is the responsibility of the individual.

Article 29: Medical expenses for hospitalization for serious diseases shall be paid according to the following methods:

(1) The minimum payment standard is in principle controlled for employees in cities, counties, and autonomous counties. 9%-11% of the annual social average salary

(2) The maximum payment limit is in principle controlled at 3-5 times the annual social average salary of employees in cities, counties, and autonomous counties in the previous year.

(3) Medical expenses above the minimum payment standard and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Appropriate care will be given to the proportion of retirees paying medical expenses. The scope of serious diseases, specific standards for deductibles and maximum payment limits, and the sharing ratio of medical expenses above the deductible standard and below the maximum payment limit shall be determined by the Provincial People's Government.

Article 30: Medical expenses below the minimum payment standard and above the maximum payment limit will not be paid by the unified fund

"Insurance Law of the People's Republic of China"

Article 22 After an insured accident occurs, when requesting the insurer to compensate or pay insurance money in accordance with the insurance contract, the policy holder, the insured or the beneficiary shall provide the insurer with the information and information that confirms the insured event that it can provide. Proofs and information related to the nature, cause, extent of loss, etc. If the insurer believes that the relevant certificates and information are incomplete in accordance with the contract, it shall promptly notify the policy holder, the insured or the beneficiary to provide supplementary information in a timely manner.