Can Jinzhou medical insurance clinic be reimbursed?

Jinzhou medical insurance clinic can be reimbursed.

The scope of medical insurance reimbursement includes outpatient service, hospitalization and serious illness, and the proportion of outpatient reimbursement is less than the other two. The reimbursement rate of outpatient service is below 50%, and the part paid by the overall fund is less, most of which is paid by the insured's personal account funds or cash.

The reimbursement scope of medical insurance generally includes:

1. List of medical insurance drugs: The list of medical insurance drugs is generally divided into Class A and Class B. All Class A drugs are included in the scope of reimbursement, and then reimbursed according to the prescribed proportion. Class B drugs need to pay a certain proportion first, and the rest are included in the scope of reimbursement, and reimbursed according to a certain proportion. And some drugs can not be reimbursed, such as: diet pills, infertility and other drugs;

2. Catalogue of diagnosis and treatment items: all the necessary, safe, effective and appropriate diagnosis and treatment items in clinical diagnosis and treatment, and the fees are customized by the price department, can be reimbursed. Other items can not be reimbursed, such as registration fee, plastic surgery, dental beauty, etc.

3. Catalogue of medical-related service facilities: generally provided by designated medical institutions. The insured generally needs to receive necessary service facilities during the process of diagnosis, treatment and nursing.

The use of medical insurance personal accounts needs to meet the following conditions:

1, has participated in medical insurance for urban workers, medical insurance for urban and rural residents and new rural cooperative medical care, and has paid medical insurance premiums;

2, medical expenses have been reimbursed in medical insurance designated medical institutions, individuals should bear part of more than the prescribed deductible;

3. The personal account of medical insurance has sufficient funds available;

4, individuals are not included in the list of arrears, nor are they included in the list of other personal accounts that are not allowed to use medical insurance.

To sum up, the specific conditions of use in different regions may be different, and the specific situation needs to refer to local regulations.

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.