1, basic medical drug expenses: the drug expenses that can be reimbursed by medical insurance include Class A and Class B;
2. Expenses of basic medical treatment projects: expenses of hemodialysis, bone marrow transplantation and other treatment projects within the scope of basic medical insurance treatment projects;
3. Cost of basic medical service facilities: the expenses incurred by the necessary living service facilities used by the insured in the process of diagnosis, treatment and nursing in designated medical institutions.
Medical insurance reimbursement process:
1, the handler submits the reimbursement documents and other materials to the social security agency for acceptance;
2. The accepting department shall review, settle accounts and pay the application materials after receiving them;
3. If the social security agency approves the application, the applicant will be reimbursed after receiving the reimbursement form of social medical insurance medical expenses.
Legal basis: Article 26 of the Social Insurance Law of the People's Republic of China.
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.
Article 29
The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, 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.