How to reimburse medical insurance for hospitalization expenses in Suzhou?

Suzhou hospitalization expenses medical insurance reimbursement process is as follows:

1. Prepare the original ID card and social security card;

2. Prepare relevant certificates of discharge, such as ID card, social security, medical records, prescriptions, expense list, discharge diagnosis certificate, etc.

3. Go to the cashier's office of the hospital for settlement and reimbursement.

Medical insurance reimbursement process in different places:

1, medical treatment in different places needs to be approved by relevant departments first. The examination and approval place for resettlement in different places is the county medical insurance center where the insured unit or street social security is located. After applying for the relevant approval form, fill in the relevant contents. Take the relevant documents to the medical insurance department of a different hospital and stamp them. Then return the relevant approval form to the applicant for approval;

2. The time limit for examination and approval in different places is generally one year, that is, from the date of handling to the date of the second year. You can't change it within a year. If the approval period has passed, the parties who are still in different places need to go to the relevant departments for re-approval. For the parties in different places, it is essential to choose a different hospital. The regulations on how many hospitals patients can choose in different regions are different. Generally, you can choose two or three;

3. It is essential for people who seek medical treatment in different places to meet reimbursement in different places. Relevant personnel need to go to outpatient department and hospital to issue receipts, lists, prescriptions, details, medical insurance manuals and case diagnosis certificates. The more detailed, the better. At the same time, don't forget to issue the registration certificate of the hospital where you go to see a doctor, so that employers, social security offices and district and county medical insurance centers can make statistical summary and audit settlement;

4. For the medical expenses incurred by the parties in designated hospitals in different places, mail the relevant reimbursement documents back to the original city for reimbursement, or ask family members to help with reimbursement in the original city. Issues such as reimbursement standards will still be in accordance with the regulations of the city, and relevant funds can be collected by family members or related accounts can be set up.

To sum up, except for the self-paid part and self-paid 10%, the part exceeding the hospital medical insurance deductible line enjoys the proportion of overall payment. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80%, and that for residents is about 70%.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.