How to reimburse the special clinic?

Medical insurance reimbursement procedures for special diseases are as follows:

1, the applicant brings the information to the medical insurance center in the district where the insured unit is located; Flexible employees directly submit the information to the medical insurance center of the insured place. The medical expenses incurred by the insured in the designated medical institutions within the jurisdiction shall be settled directly with the social security card.

2. The medical expenses incurred by the insured in non-designated medical institutions or designated medical institutions outside the city shall be paid by the insured himself, and the required information can be used to go through the reimbursement procedures in Jinan social security institutions.

Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC).

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.

What does the reimbursement scope of medical insurance generally include?

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.