Dingyuan wanjia reimbursement rules

Legal analysis: First, medical insurance cannot be bought and used immediately. Medical insurance must be paid continuously for a certain period of time before it can be reimbursed. Employees' medical insurance can only be reimbursed the next month, and some places require continuous payment for six months before reimbursement. Medical insurance for urban residents and the new rural cooperative medical system are paid in the same year and will take effect next year, which means that the illness expenses will not be reimbursed until next year.

Second, there are designated institutions for medical insurance reimbursement. You'd better go to designated institutions and pharmacies to buy medicine to prevent reimbursement. However, there are several special circumstances that can be reimbursed in non-designated hospitals: those who need to be transferred to hospital for treatment in time due to illness, go through the formalities of regularization and pass the examination and approval; When a major disease occurs, the nearest emergency treatment in a non-designated medical institution will be carried out continuously for 72 hours; Medical expenses for ambulance emergency rescue.

Third, private transfer cannot be reimbursed. If you want to be transferred to hospital for treatment, you must first apply for regularization, and the reimbursement can only be made after the transfer procedure is completed.

Fourth, medical insurance reimbursement can only be reimbursed if it exceeds the deductible line. In other words, after deducting the individual's own expenses, the rest above the deductible can be reimbursed.

Five, medical insurance reimbursement has a cap line, and the part that exceeds the cap line cannot be reimbursed. The capping line is formulated according to local medical insurance policies, which may be different from place to place. It is suggested that when you buy a bag, you should buy a medical insurance for serious illness, so as to further protect the high medical expenses incurred by patients with serious illness on the basis of basic medical insurance. The general price is around 100 yuan.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.