Only the actual medical expenses incurred by the insured are reimbursed, and the reimbursement scope of different commercial medical insurance is different. Expense reimbursement insurance can reimburse hospitalization medical expenses, but different products have different provisions on the scope of reimbursement. Some commercial medical insurance contracts stipulate that the actual medical expenses must be reimbursed within the scope of social security reimbursement.

If compensation has been obtained from social security or other social welfare institutions, the insurance company will only pay the rest, if social security cannot be reimbursed (imported drugs, specific drugs, intensive care units, etc.). ), such commercial medical insurance can not be reimbursed, and its role is only to compensate for the part that needs to be borne by itself in proportion after social security reimbursement. However, some commercial medical insurance stipulates that as long as the actual and reasonable expenses are incurred, the insurance company can make compensation in proportion or after a certain deductible.

2. The reimbursement scope of urban medical insurance:

The following expenses incurred by the insured in designated medical institutions and retail pharmacies are included in the reimbursement scope of the basic medical insurance fund for urban residents:

(a) hospitalization expenses;

(two) medical expenses within 7 days before emergency observation and hospitalization;

(three) the medical expenses for special diseases in urban residents' outpatient clinics;

(4) Other expenses that meet the requirements.