Specific explanation of medical insurance reimbursement for employees in Xinjiang

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Retired workers of Xinjiang Corps are generally not allowed to see a doctor in Xi 'an. However, except for one of the following circumstances:

1, living in Xi 'an after retirement;

2. Due to the limitation of medical conditions in Xinjiang, I was transferred to Xi 'an for treatment at the suggestion of a local tertiary hospital;

3, visiting relatives, traveling in Xi sudden illness;

Belong to the above two or three cases, medical expenses need to be paid in advance and reimbursed back to Xinjiang, and the third item needs to be called to the Corps Medical Insurance Bureau for the record within the specified time after admission; In the third case, the case is filed with the local medical insurance bureau in Xinjiang, and the Xi 'an Medical Insurance Bureau will settle the case locally according to the regulations of Xinjiang.

Ministry of Human Resources and Social Security, Ministry of Finance

Notice on Doing a Good Job in Direct Settlement of Medical Expenses of Inpatients in Different Provinces of Basic Medical Insurance

No [20 16] 120 issued by Ministry of Human Resources and Social Security.

Third, standardize the process of medical treatment in different places.

(5) standardize the transfer-out process. The insured shall register with the agency of the insured place before seeking medical treatment across provinces. In accordance with the local regulations, the handling agency of the insured place handles the procedures for filing medical records in different places for the insured, and establishes a database of medical records in different places to realize dynamic management. The insurance agencies will report the information of medical personnel in different places to Ministry of Human Resources and Social Security social insurance agencies (hereinafter referred to as ministerial agencies) to form a national database of medical personnel in different places for medical institutions and designated medical institutions to obtain the information of medical personnel in different places.

(6) Standardize the settlement process. When the insured person is discharged from hospital in different places, the agency in different places will transmit the hospitalization expenses and other information to the agency in different places in real time through the national settlement system for medical treatment in different places, and the agency in different places will calculate the amount that the insured person and various medical insurance funds should pay according to local regulations, and send the calculation results back to the designated medical institutions in different places through the national settlement system for direct settlement between the designated medical institutions and the insured person.

Corps No.7 Division Social Security Bureau

Need to know the basic medical insurance for the residents of the seventh division.

Two, the insured workers (individuals), residents transfer management measures

1. If the insured employees (individuals) really need to be referred or transferred because of their illness, the second-level designated hospitals in the overall planning area will issue a transfer certificate and transfer them to the 13 medical institution designated by Urumqi Corps for hospitalization. Before the direct settlement of the designated medical institutions in Urumqi, they should register with the medical insurance department of the social security center within 48 hours (except for injuries).

2. If the insured employee (individual) really needs to be referred or transferred to other medical institutions in Xinjiang for hospitalization due to illness, the second-level designated hospital in the overall planning area will issue a transfer certificate, and it is not necessary to register with the Medical Insurance Department of the Social Security Center of the Division. After discharge, submit the invoice, expense summary, copy of medical records, transfer certificate, admission certificate, discharge certificate and other related bills to the unit for reimbursement.

3. Insured employees (individuals) who are sick and need to be referred or transferred to medical institutions outside Xinjiang for hospitalization due to their illness shall be issued with a certificate of transfer by a third-class first-class hospital in Xinjiang, signed by the leaders of the social security center, and filed by the medical insurance department. After discharge, submit the invoice, expense summary list, copy of medical records, transfer certificate, admission certificate, discharge certificate and other related bills to the unit for reimbursement.

Five, the local retired workers (individuals), residents with their children in different places to live or travel, visit relatives during the medical reimbursement management measures.

1. Local retirees should first fill out the Application Form for Local Retirees (Retired) of the Seventh Division to Live with Their Children in Different Places, and then register with the Medical Insurance Department of the Social Security Center of the Division.

2. Local individual retirees and residents directly go to the business counter of the Medical Insurance Department of the Social Security Center of the Division to handle the temporary residence of the local retirees (retired) of the Seventh Division to their children in different places.

3 retirees travel and visit relatives due to sudden illness, according to the "measures" of medical management of workers fourth.

Four, the insured workers (individuals), residents on business, work, study, visit relatives, travel during the medical management measures.

Insured employees (individuals) and residents who have sudden illness during going out can be hospitalized in the nearest emergency department, and call the medical insurance department of the Social Security Center of the Seventh Division for the record within 48 hours. After discharge, you need to provide hospital invoices, hospitalization certificates, hospitalization expenses summary, emergency diagnosis certificates and emergency invoices, discharge certificates, emergency hospitalization medical records, etc. , and submit it to the insured unit for reimbursement (the business trip requires a certificate from the unit and a report on home leave, and it is not reimbursed for non-emergency situations).