How to deal with the medical insurance door

The purpose of medical insurance is to ensure the medical insurance benefits of patients with special diseases when they seek medical treatment in outpatient department.

First, understand the medical insurance policy

First of all, individuals need to know the special medical insurance policies in their areas, including which diseases belong to special outpatient diseases, which medical insurance benefits they enjoy, and the conditions for handling them. This information can be inquired by the local medical insurance department, social security center or relevant official website.

Second, prepare relevant materials.

According to the policy requirements, prepare relevant medical proof materials, such as diagnosis certificate, medical record book, inspection report, etc. These materials need to be certified by qualified medical institutions to prove that individuals do have special outpatient diseases.

Third, fill in the application form and submit it.

Go to the local medical insurance service window or designated medical institutions to receive and fill out the medical insurance application form. When filling in the application form, you need to fill in personal information, disease diagnosis and medical records in detail. At the same time, submit the prepared relevant materials together.

Four. Review and processing

The medical insurance department will review the submitted materials to verify whether the individual meets the medical insurance conditions. After the examination and approval, the medical insurance department shall register for the record and handle the relevant formalities for the individual.

Verb (abbreviation of verb) enjoys medical insurance benefits.

After successful handling, individuals can enjoy special treatment of medical insurance in outpatient service, such as higher reimbursement ratio and wider reimbursement scope. See local policies for specific treatment standards.

It should be noted that the process and requirements of medical insurance may vary from place to place. Individuals need to know the local policies in detail before handling them, and prepare relevant materials and fill in the application form as required. At the same time, the medical insurance treatment standard may also be adjusted, and individuals need to pay attention to policy changes and keep abreast of relevant information.

To sum up:

The purpose of medical insurance is to ensure the medical insurance benefits of patients with special diseases when they seek medical treatment in outpatient department. Individuals need to understand local policies, prepare relevant materials, and fill in the application form and submit it. After examination and approval, you can enjoy preferential treatment of medical insurance. In the process of handling, individuals need to pay attention to policy changes and abide by relevant regulations.

Legal basis:

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

Article 23 provides that:

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 28 provides that:

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.