How to reimburse foreign medical insurance to see a doctor in Suzhou

The process of reimbursement of medical insurance for foreign medical insurance in Suzhou is as follows:

1. Those who seek medical treatment in a different place need to go through the approval of the relevant departments first. The approval of the relocation of the place: the participating units or street social security in the district and county health insurance center. After applying for the relevant approval sheet, fill in the relevant content. Bring the relevant documents to the medical insurance department of the hospital in the other place for stamping. Then return the relevant approval sheet to the application of the local agency for approval;

2, the approval of the period of time is usually one year, specifically that is, the person from the date of the start to the day of the second year. It is not possible to change within one year. If the approval period has expired, the party still in the off-site will need to go to the relevant departments for re-approval. It is essential for those who are in a foreign country to choose a hospital in the foreign country, and the rules for how many hospitals can be chosen by those who are seeking medical treatment vary from region to region. Generally, you can choose two to three;

3, the people who are essential to encounter the foreign reimbursement of things, the relevant people need to go to the outpatient clinics, hospitals issued receipts, lists, prescription bottoms, details, medical insurance manuals, diagnostic proof of the case, the more detailed, the better. At the same time, you should not forget to issue a certificate of registration of the hospital you are attending, in order to facilitate the employer, the social security office, the district and county health insurance centers to carry out statistical summaries and audit and settlement of the work;

4, the person concerned in the designated hospitals in other places in the medical expenses incurred, will be related to the relevant reimbursement documents will be mailed back to the original city for reimbursement, but also allow family members to reimbursement of the city of origin in the original help. The standard of reimbursement will still be in accordance with the regulations of the host city, and the relevant money can be collected by family members, or you can set up your own account to collect the relevant money.

Chronic health insurance reimbursement standards:

1, Class A chronic disease patients incurred in accordance with the provisions of the outpatient medical costs, by the integrated fund at 85% payment. The outpatient hemodialysis cost, peritoneal dialysis cost and the cost of taking cyclosporine A after organ transplantation for patients with chronic renal failure in the stage of renal failure will be increased by ten percentage points on the basis of the above;

2. Starting line standard for chronic diseases of category B: 300 yuan. The outpatient medical expenses incurred by patients with Class B chronic diseases in accordance with the regulations shall be paid at 80% of the portion above the starting line standard, and the maximum payment limit for chronic diseases shall not be exceeded in a medical year or within the validity period;

3. Participants can be recognized with two Class B chronic diseases at the same time, and the management of the two diseases shall be based on the first recognized, and the starting line shall be calculated separately for each disease type. The management of the identification of chronic diseases and the maximum payment limit will be adjusted by the human resources and social security department in due course according to the income and expenditure situation of the integrated fund. The criteria, rules and procedures for the identification of chronic diseases will be formulated separately by the municipal human resources and social security administration.

In summary, the insured can seek medical treatment at the recognized designated medical institutions in other places only after going through the procedures of confirming medical treatment in other places. The individual medical account amount can be withdrawn from any of the business outlets with the medical insurance card, and can be used to pay for outpatient general illnesses and to purchase and dispense medicines at pharmacies. Participants can go to the local designated medical institutions for inpatient hospitalization and outpatient treatment of specific items, and the medical expenses will be paid by the individual first.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses in line with the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical services and facilities, as well as emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.