Hangzhou special case medical insurance application process

The application process for medical insurance for special cases in Hangzhou is as follows:

Step one: Go to the medical record room to copy the relevant discharge summary, pathology report and other supporting materials. (This is probably only available for patients who are hospitalized. Those who are not hospitalized should ask the medical insurance center)

Step 2: At the medical insurance office of the hospital where you are treated, receive a special disease application form in duplicate

Step 3: Ask the attending doctor to fill in the application form and sign it. After it is signed by the department director, it will be submitted to the hospital’s Medical Insurance Office for sealing and confirmation.

Step 4: According to the type of provincial medical insurance or municipal medical insurance you apply for, go to the relevant medical insurance center to apply for review and confirmation of special diseases.

Step 5: Wait for confirmation from the Medical Insurance Center to take effect.

It is estimated that the medical insurance centers in different places will have slightly different requirements, and different types will have different requirements. If you need it, try to go to the hospital medical insurance office or the local medical insurance center to consult and apply.

Insured persons suffering from specified diseases can bring the "Hangzhou Basic Medical Insurance Outpatient Treatment Recommendations for the Specified Diseases" issued by the city's second-level and above designated medical institutions, medical records and relevant examinations, Laboratory reports and other information, as well as one recent one-inch photo, must be registered with the medical insurance agency and apply for the "Outpatient Medical Record for Special Types of Diseases stipulated in Hangzhou Basic Medical Insurance".

Special outpatient diseases refer to chronic diseases that can be treated as outpatients and do not require hospitalization, but still require long-term reliance on drugs to maintain stable conditions. It usually refers to diseases such as malignant tumors requiring radiotherapy and chemotherapy, renal insufficiency requiring long-term renal dialysis treatment, and long-term anti-rejection drug treatment after kidney transplantation.

Since many special diseases require outpatient treatment or long-term medication, after special disease approval, you can choose a hospital as a designated hospital for special diseases, and the special disease expenses incurred in the outpatient department can be reimbursed according to the overall hospitalization ratio, and can Medical treatment according to the billing method reduces the patient's personal burden. As the level of medical insurance in various regions improves, many regions are now gradually including more diseases into the scope of special diseases.

What is "special disease"

The commonly referred to as "special disease" is also called "three special diseases", which refers to the general scope of special diseases including the following three diseases:

1. Renal insufficiency requires long-term dialysis treatment;

2. Malignant tumors require radiotherapy and chemotherapy;

3. Long-term antibiotics are required after kidney transplantation. Rejection drug treatment.

Selection and change of designated hospitals for "special diseases"

Insured persons can choose the designated medical institution or the designated basic medical specialty and traditional Chinese medicine hospital in Beijing A designated medical institution for special diseases can go to a designated hospital for special diseases after diagnosis and a "Beijing Medical Insurance Special Disease Declaration and Approval Form" issued by the hospital where you seek medical treatment and approved by the unit and the medical insurance center.

The approval period is 360 days and cannot be changed without reason within one year. After the approval period expires, insured persons can apply for changes or extensions. Once an insured person suffers from a special disease and chooses a designated medical institution that is reviewed and approved by the Medical Insurance Center, the special disease expenses incurred in the outpatient service can be reimbursed according to the overall hospitalization ratio, and medical treatment can be based on the billing method.

It reduces the patient's personal burden, and there is no need to pay deductible fees for hospitalization due to other diseases. Insured persons suffering from "special diseases" who are relocated can identify one of the two local medical insurance medical institutions of their personal choice as a designated medical institution for "special diseases" in the relocation, and the approval procedures are the same as in this city.