1. medical insurance fund source: Baoji employee medical insurance fund is partly from the insurance premiums paid by individuals and partly from the contributions paid by enterprises;

2. Use of medical insurance fund: Baoji employee medical insurance fund can pay medical expenses incurred by insured employees in designated medical institutions, including outpatient expenses and hospitalization expenses;

3. Medical insurance reimbursement policy: Baoji implements the medical insurance outpatient system for employees, co-ordinates the establishment of general outpatient clinics, and gradually includes the medical expenses of frequently-occurring diseases and common diseases in outpatient clinics into the payment scope of the overall fund.

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, Baoji medical insurance outpatient service can be reimbursed because the medical insurance fund is sufficient, and the policy stipulates the reimbursement method and proportion of medical insurance outpatient service expenses for employees.

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.