'how to settle the medical settlement in different places now? Can I use the medical insurance card directly when I see a doctor in different places?' for many people who see a doctor in different places, how to reimburse is also a very troublesome thing. Many people don't know the specific operation process. Let's understand it together.
Our medical reimbursement is divided into local medical treatment and non local medical treatment. At present, the settlement of cross provincial and non local medical treatment is still in the stage of policy implementation. All regions are stepping up to formulate their own implementation policies. Some places have achieved the non local reimbursement of medical insurance, such as Jilin and Hainan, and some places are not yet available. At present, the reimbursement procedures of local and remote medical treatment in most regions are different~
One
Local medical treatment
We see doctors in the place where our social security relationship is located, which belongs to local medical treatment, and there are different types of local medical treatment.
1. Hospitalization reimbursement
If they need to be hospitalized, they need to take their ID card and social security card to the designated medical institutions for medical treatment and hospitalization procedures. When they are discharged from the hospital, they need to make medical insurance settlement directly. The medical expenses paid by the medical insurance co-ordination fund shall be settled by designated medical institutions and social security agencies; the medical expenses paid by individuals shall be settled by small partners directly with designated medical institutions.
2. Outpatient treatment of special diseases
Application: if you have special diseases, you need to go to the clinic for treatment. A small partner is required to bring his / her recently hospitalized disease diagnosis certificate, discharge summary or examination report within the past six months, and the disease diagnosis certificate to fill in the form and apply in the designated medical institution of medical insurance. After the preliminary review by the relevant departments of the hospital and the review and approval by the Social Security Bureau, the small partners can enjoy the reimbursement treatment of outpatient special diseases in the next month.
Reimbursement: after the treatment, the small partner needs to take his / her social security card to go to the designated hospital of the declared medical insurance for outpatient treatment of special diseases. When settling the account, the small partner can directly settle the medical insurance in the hospital. The medical expenses paid by the medical insurance co-ordination fund are settled by the designated medical institution and the social security agency; Medical expenses paid by individuals shall be settled by the insured and designated medical institutions.
In addition, some ordinary outpatient clinics can also be reimbursed by medical insurance, such as Beijing, but most parts of the country are not allowed, so it depends on your local regulations.
Two
Seek medical treatment elsewhere
For medical treatment in different places, in areas where direct settlement is not possible, the original reimbursement method needs to be implemented. Here is a problem that you must pay attention to:
According to many local regulations, medical treatment in different places should be applied to relevant departments first. The insured of urban employee medical insurance and urban resident medical insurance should go to the human resources and social security department to apply, and the insured of new rural cooperative medical insurance should go to the health department to apply. Only after being approved can the expenses of medical treatment in different places be reimbursed. Or the hospital will issue a referral certificate. If these two documents are not available, the medical expenses cannot be reimbursed back to the local area!
After the small partner is discharged from the hospital in a different place, the individual needs to pay all the hospitalization expenses in advance. After that, I will go to the social security bureau to apply for hospitalization reimbursement with the social security card, hospitalization invoice, hospitalization home page and discharge summary, medical expenses summary list and the passbook of the reimbursement applicant. If the application for referral has been processed, the referral certificate shall be provided; if the registration of non local residents has been processed, the registration form of non local residents shall be provided.
Of course, the settlement of medical treatment in different places is gradually coming into effect. If you have access to the national settlement platform locally, as long as you are the insured who meets the conditions of medical treatment in different places, after registration with the relevant departments, you can go to the designated medical institutions in different places for medical treatment, which is convenient for you to follow the local medical hospital. Just show your social security card and pay the self paid part~
According to the prediction of the Ministry of human resources and social security, by the end of this year, the whole country will have to complete the settlement of medical treatment in different places, which will be convenient then!