The timeliness of medical insurance (medical insurance) reimbursement is generally stipulated by local medical insurance policies, and the specific provisions may vary. But in general, Medicare reimbursement generally follows the following principles.
Medicare reimbursement is usually time-sensitive for one year, i.e., from January 1 to December 31. Therefore, medical expenses incurred in December should be reimbursed within the current year.
In principle, medical expenses that have passed the reimbursement period cannot be reimbursed. However, some regions may make adjustments for specific situations, such as:
If the reimbursement is not made in time due to objective reasons (such as inconvenient transportation, serious illness, etc.), the reimbursement period can be appropriately extended after review.
For chronic diseases or special diseases, there may be special statutes of limitations for reimbursement.
In general, medical insurance reimbursement cannot be cross-year. That is, medical expenses incurred in December cannot be reimbursed in the following year. However, exceptions may be made in the following cases:
Outpatient Critical Illness Insurance: Outpatient critical illness insurance usually has a longer reimbursement period, and some regions allow cross-year reimbursement. The specific reimbursement time limit needs to consult the local medical insurance agency.
Reimbursement of hospitalization expenses: For those who have been hospitalized for a long time** and are hospitalized across years, some regions allow cross-year reimbursement. The specific reimbursement time limit needs to consult the local medical insurance agency.
In addition, in case of special circumstances, major natural disasters, public health emergencies, etc., the medical insurance department may extend the reimbursement time. The specific situation is subject to the official announcement of the medical insurance department. In order to avoid missing out on medical insurance reimbursement, it is recommended to contact the local medical insurance agency in time after the medical expenses are incurred to understand the specific reimbursement time limit.