1, medical registration. Before seeing a doctor, you need to register at the hospital registration window, and you need to show your ID card and medical insurance card when registering.
2. Medical expenses. In the process of seeing a doctor, the doctor will prescribe corresponding drugs and examination items according to the condition, and the patient needs to pay. At this time, you can show your medical insurance card for settlement. The medical insurance system will automatically calculate the expenses within the scope of medical insurance and deduct the part that should be reimbursed from the total expenses;
3. Go through the reimbursement procedures. You can go to the hospital medical insurance window for reimbursement after seeing a doctor. The invoice and the medical insurance card need to be submitted together, and the staff of the medical insurance window will make accounting and reimbursement according to the medical insurance regulations.
Medical insurance reimbursement conditions:
1. Confirm the insured status: before seeking medical treatment, you need to confirm that you have participated in local medical insurance, which can be confirmed by means of social security card and medical insurance certificate;
2. Medical category: Medical insurance generally only reimburses therapeutic medical behaviors, such as outpatient service, hospitalization, surgery and examination. Some cosmetic medical behaviors, such as dental beauty and plastic surgery, are usually not covered by medical insurance reimbursement;
3. Medical expenses: Medical insurance will only reimburse medical expenses that meet the requirements, such as medical expenses, medicine expenses, examination expenses, operation expenses, etc. Personal expenses, medical insurance will not be reimbursed;
4. Hospital qualification: Medical insurance will only reimburse the medical expenses of legally operated medical institutions, such as public hospitals and qualified private hospitals. Medical insurance will not be reimbursed for illegal medical institutions or clinics.
To sum up, when using the medical insurance card, you need to protect your medical insurance account number and password to avoid information leakage and abuse. At the same time, we also need to know the local medical insurance policies and regulations in order to use the medical insurance card correctly and legally.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.