How to reimburse Medicaid for critical illness?

The reimbursement steps of Medicaid for critical illness are as follows:

1. After the seriously ill patients are hospitalized, they must send the medical certificate, my basic medical insurance diagnosis and treatment manual and other materials to the medical insurance department of the hospital where they live for registration and verification, so as not to affect the reimbursement of hospitalization medical expenses.

2. Outpatient medical expenses need to be reimbursed according to the specified time. There are two outpatient reimbursement opportunities at the end of each quarter for 23 diseases such as liver cirrhosis and 7 diseases such as leukemia.

Does not belong to the scope of reimbursement of serious illness medical insurance.

1, see a doctor in a non-designated hospital without approval (except for emergency rescue)

2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries; Injuries caused by traffic accidents (commercial accident insurance is recommended)

3, because of my illegal injury.

4. Food poisoning caused by accidents.

5. Suicide treatment (except psychotic episode)

6. Injuries caused by medical accidents.

7, according to the provisions of the state and the city medical expenses should be self-care (suggested to buy commercial supplementary medical insurance).

To sum up, Medicaid for serious illness can bring relevant materials to the medical insurance management center for reimbursement.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.