Application scope of Beihai medical insurance card

Scope of use of medical insurance card:

The scope of use of medical insurance card mainly includes the following three aspects.

Used to buy medicine: when the insured person buys medicine at the designated pharmacy, he can pay with the medical insurance card.

Used for reimbursement: if you go to the hospital for medical treatment, whether out-patient or in-patient, reach the medical insurance deductible line and are within the scope of medical insurance reimbursement, you can use the medical insurance card for reimbursement.

Used for seeing a doctor: when the participants are sick, they can register and see a doctor at the designated hospital with the medical insurance card and medical insurance manual. The main process is as follows: holding the medical insurance manual and medical insurance card-registering with the hospital medical insurance office-reviewing the card-paying the hospitalization deposit-hospitalization-the patient agrees to the self-funded project and signs it-cash or medical insurance card.

Among these three medical insurance cards, consumers are most concerned about the insurance use of medical insurance cards. Consumers who participate in medical insurance can use the medical insurance card for reimbursement after seeing a doctor in the hospital, so how should they be reimbursed? Medical insurance card reimbursement can be mainly divided into two aspects: hospitalization and outpatient serious illness.

Medical insurance card reimbursement process:

First, the medical insurance card hospitalization reimbursement process:

First, patients hospitalized in designated medical institutions in the region.

Show your medical insurance card first, and then pay a certain threshold fee according to the level of the hospital. After discharge, you can enjoy medical insurance benefits at the hospital medical insurance settlement office.

B, reimbursement procedures for inpatients in different places

(1) Reporting settlement data

Please bring the following information for reimbursement of hospitalization in different places.

1, hospital invoice (seal)

2. Detailed list of hospitalization expenses (seal)

3. Discharge record (seal)

4, the use of drugs outside the directory and special diagnosis and treatment project copy (seal)

5. Medical insurance card

6, complete procedures of "Wuhan caidian district urban workers medical insurance referral form".

(2) Settlement

The hospitalization procedures in different places are complete, and the reimbursement will be settled with the receipt and my ID card (the consignee needs to provide the consignee ID card) after 5 working days. Reimbursement will be suspended from 28th to the end of each month, and resumed the following month 1 day.

Second, the outpatient reimbursement procedures for seriously ill patients

(1) reimbursement time

Reimbursement time of hypertension and diabetes in critical outpatient department: 1 quarter March; The second quarter is June; The third quarter is September; The fourth quarter is 65438+February.

The outpatient department of other diseases is reimbursed once a month.

(2) Reporting settlement data

1, outpatient medical receipt; 2, Chinese prescription unit price and seal; 3. Check the original attached inspection report.

(3) Settlement

After completing the formalities, the reimbursement amount will be directly transferred to my bank passbook after 5 working days.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.