How to use the medical insurance card in Beijing is the most cost-effective?

Medicare payment is divided into individual account and coordinated account. The reimbursement of medical expenses above the base amount of 1800 RMB is paid through the integrated account of the medical insurance. If there is no more than 1800 yuan base, the balance of the individual account in the medical insurance card can be used to pay, that is, the part of the individual to pay is the balance into the individual account, so the individual did not pay medical insurance premiums for nothing.

I, Beijing medical insurance card use of the new provisions

1, artificial organs reimbursement increased by 50%. The new health insurance policy introduced this time adjusted the reimbursement standard of artificial organs, increased by 50% on the current level. The scope of reimbursement includes pacemakers, heart valves, artificial crystals, artificial joints, artificial blood vessels, the installation of implantable cardioverter-defibrillator and other artificial organs within the body.

2. 110 new medical programs added to Medicare. Another major adjustment is the inclusion of 110 medical items in the Medicare program. These new additions include familiar medical items.

2. Beijing's medical insurance reimbursement process

1. When you visit a doctor with a social security card, you only need to pay out-of-pocket expenses, and reimbursable expenses will be settled by the medical institution and the relevant departments of the medical insurance. But if the emergency department does not carry a social security card, or his special circumstances, you can pay the full amount of their own medical expenses, and then the next time you go to the hospital, you can take the bill and the health insurance card to the designated window for reimbursement.

2. Outpatient (emergency) clinic: filed card, medical insurance card, medical expense receipt, uniform receipt, foreign party, details, Beijing bank statement (not retained). If trauma treatment is sought, a description of the cause of the trauma and medical records should be provided.

3. In case of emergency detention, a certificate of diagnosis, prescription with emergency stamp, details of examination and treatment, receipts, medical insurance card, filing card and bank statement should be provided.

4. For hospitalization expenses, it is necessary to provide a certificate of diagnosis of hospitalization, a certificate of discharge, a real-time settlement statement (full settlement voucher), receipts, details of hospitalization expenses, a copy of the medical record (stamped with the seal of the hospital), a medical insurance card, a filing card, and a bank statement.

5. Returning to the hospital from a different place requires a diagnosis certificate, a discharge certificate, receipts, cost details, medical insurance card, archive card, bank statement and an explanation of the reason for hospitalization in a different place.

From January 1, 2021, the maximum payment limit of the fund for outpatient and emergency medical expenses incurred by urban and rural residents' basic medical insurance participants in a medical insurance year was raised from 4,000 yuan to 4,500 yuan. In Beijing, the reimbursement rate for active employees is more than 85%, and the reimbursement rate for retirees is more than 90%, up to 99.1%, with a maximum limit of 500,000 yuan.