1. The coverage of trade union mutual medical insurance includes reasonable and necessary outpatient medical care, hospitalization medical care, outpatient medical care, hospitalization medical care and other expenses, which limits the scope of social security, and the deductible line, capping line and reimbursement ratio will be limited. The local medical insurance policy will prevail, and there will be some differences in different places. In addition, the trade union mutual medical care belongs to the reimbursement type, and there are hospitalization expense lists, payment invoices, inspection documents, diagnosis certificates, etc. Reimbursement is required, and some of them can be reimbursed directly at the time of discharge settlement.

2. Legal basis: Article 25 of the Social Insurance Law of People's Republic of China (PRC).

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Second, what is the reimbursement process of trade union medical mutual assistance?

Labor Union Medical Mutual Assistance Reimbursement Process:

1. Submit a copy of last month's payroll without employee's signature, and all employees are required to participate, except the over-age personnel, male 60 years old, female 50 years old, and interns;

2. Submit the list of the insured with official seal;

3. It will take effect after payment, with one year as a cycle;

4. Submit materials for reimbursement, such as employee ID card, expense invoice, disease certificate, discharge summary, expense summary, long-term and short-term doctor's advice, etc. Those who have participated in the new rural cooperative medical system must also provide the hospitalization expenses statement of the participants. The above does not require originals, only copies;

Expenses less than 5.3000 yuan can be paid on the spot, and those more than 3,000 yuan can be paid within one week after being approved by the regional trade union.