Outpatient expenses can be reimbursed by medical insurance.

The reimbursement scope of medical insurance includes outpatient service, hospitalization and serious illness. However, the proportion of outpatient reimbursement is less than the other two items. Under normal circumstances, the outpatient reimbursement ratio is less than 50%, and the part paid by the overall fund is smaller. Most of it is paid from the insured's personal account funds or cash.

The medical insurance reimbursement process is as follows:

1. The original copy of my ID card or social security card;

2. The third or second level of designated medical institutions Original disease diagnosis certificate issued by a specialist in the hospital;

3. Original medical records, examinations, test results reports and other medical information;

4. Financial and tax unified medical institutions Original outpatient fee receipt;

5. Outpatient fee detailed list printed by the hospital computer or the original payer of the prescription issued by the doctor;

6. Designated pharmacies: unified tax merchandise sales invoice and computer Print the original copy of the list;

7. If applying on behalf of an agent, provide the original ID card of the agent.

Commercial medical insurance can be divided into reimbursement medical insurance and compensation medical insurance.

Reimbursement medical insurance means that the medical expenses incurred by patients in the hospital are reimbursed by the insurance company. It is generally divided into outpatient medical insurance and inpatient medical insurance.

Indemnity medical insurance means that the patient is clearly diagnosed by the hospital as suffering from a certain disease listed in the contract, and the insurance company pays the patient for treatment and care based on the amount agreed in the contract. Generally, it is divided into individual disease insurance and critical illness insurance.

Medical insurance, like other types of insurance, collects medical insurance premiums in advance from people who are threatened by the disease in the form of a contract to establish a medical insurance fund; After medical expenses are incurred when visiting a medical institution, the medical insurance institution will provide certain financial compensation. Therefore, medical insurance also has two major functions of insurance: risk transfer and compensation transfer. That is, the economic losses caused by disease risks on an individual are distributed to all members threatened by the same risks, and a centralized medical insurance fund is used to compensate for the economic losses caused by the disease.

Legal Basis

"Social Insurance Law of the People's Republic of China"

Article 28 In line with the basic medical insurance drug catalog, diagnosis and treatment items, medical Service facility standards and emergency and rescue medical expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

Warm reminder

The above answers are only based on the current information and my understanding of the law. Please refer to it with caution!

If you still have questions about this issue, it is recommended that you sort out the relevant information and communicate with professionals in detail.