Mainly depends on product settings. In case of hospitalization reimbursement, it is 80%-95%, depending on the product.
The proportion of hospitalization reimbursement in commercial insurance varies according to the level of hospitals and medical expenses, so the proportion of hospitalization reimbursement is also different. Commercial medical insurance is an integral part of the medical security system, and units and individuals voluntarily participate. The state encourages employers and individuals to participate in commercial medical insurance.
What is the specific process of reimbursement of commercial medical insurance? 1. Notify the insurance company in time after the insurance accident happens;
2. With the assistance of the insurance company, prepare the materials needed to apply for reimbursement: if it is an outpatient clinic, outpatient medical records and outpatient invoices are generally needed. If you are hospitalized, you generally need a disease diagnosis, a discharge summary, a medical insurance statement, a list of hospitalization expenses, and an invoice for hospitalization expenses. If it is an accident, it is generally necessary to provide accident certificates.
3. The insured has completed the diagnosis and treatment, and the materials are fully prepared, and applied to the insurance company for reimbursement;
4. If the insurance company approves, it can be reimbursed.
Hospitalization reimbursement is 80%-95%, depending on the product.
Legal basis:
"People's Republic of China (PRC) Social Insurance Law" Article 23 * * * employees shall participate in the basic medical insurance for employees, and employers and employees shall pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.