First of all, the question does not describe the issue of "self-paid drugs" reimbursed by commercial medical insurance
Generally, self-paid drugs refer to this
Including Class C drugs , the out-of-pocket portion of Class B drugs, the out-of-pocket portion of Class B equipment and equipment, and other items not covered by social security. Regarding the guide to medical insurance reimbursement, I have just compiled the relevant content. I hope it will be helpful to you: 2020 National Social Security and Medical Insurance Application Reimbursement Process! Nowadays, many hospitals do not have self-paid drugs, so they have to go to outside pharmacies to buy them.
The problem is that commercial medical insurance reimburses self-purchased drugs outside the hospital
The cost and invoice of self-purchased drugs, and It is not included in the hospital's expense list and invoice. You need to go to a designated pharmacy to buy it.
Then, most commercial medical insurance only reimburses the expenses incurred in the hospital, such as hospitalization and special outpatient services. Your hospital will outsource it. Medicines will not be reimbursed according to insurance liability.
Remember, most commercial medical insurance does not reimburse.
Some commercial medical insurances, if the procedures are complete, will be reimbursed as appropriate after review. The required materials are:
1. Purchase of medicines from designated pharmacies or designated pharmacies for social security Invoice
2. Prescription signed by the doctor
3. Drug-free certificate stamped by the medical office
Among them, due to the proportion of drugs, as well as the hospital and Doctors may be subject to liability penalties.
The drug-free certificate stamped by the medical office is very, very difficult to obtain. It may be issued if you are hospitalized, but it is basically impossible to issue it in the outpatient department.
The following is an actual claim settlement case for drugs purchased outside the hospital. Many people are talking about the theory, but it is really difficult in practice