Hospital outpatient expenses belong to the scope of reimbursement of basic medical insurance, so as long as the insured person goes to the designated hospital for outpatient treatment, the outpatient expenses can be reimbursed through basic medical insurance. The insured person can hold the social security card and settle directly at the outpatient toll collection office.

Different regions, different hospitals, different drugs and treatment methods will lead to different reimbursement rates. If people want to reimburse outpatient expenses, then the expenses must exceed the deductible line of outpatient medical insurance reimbursement. The scope of medical insurance reimbursement includes outpatient service, hospitalization and serious illness. However, the proportion of outpatient reimbursement is less than that of the other two. Under normal circumstances, the proportion of outpatient reimbursement is below 50%.

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, the specific reimbursement ratio and policies may vary by region and time. You can consult the local medical insurance department or the medical insurance Commissioner of the hospital.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

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.