How to reimburse social security hospitalization in Zhuhai

The medical expenses for medical treatment in different places shall be paid in advance by the individual, and shall be reimbursed by himself or his agent to the medical insurance center after the treatment.

The following materials shall be prepared for reimbursement of medical expenses of insured employees:

Personal medical insurance certificate;

Approval documents of hospitals above Grade 3A in this Municipality (single referral);

Hospital invoice, expense summary list and discharge summary stamped by the hospital;

The original and photocopy of the ID card of the agent, and the valid bank card or passbook of the reimbursement personnel.

Proportion of reimbursement in different places:

The reimbursement rate of the threshold fee above 3,000 yuan is 88%, that of 3,000-5,000 yuan is 90%, that of 5,000-10000 yuan is 92%, and that of10000 yuan is 95%, of which 80% is Class B drugs, and 70% is expensive drugs and special examination and treatment.

Medical insurance reimbursement process in different places:

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.

The time limit for 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.

For the medical expenses incurred by the parties in designated hospitals in different places, the relevant reimbursement documents will be mailed back to the original city for reimbursement, or family members can be asked to help reimburse 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.

Proportion of medical insurance reimbursement in different places:

Medical expenses of individual medical insurance accounts can be transferred to Zigui Medical Insurance Bureau regularly, and hospitals in other provinces should be designated hospitals for local medical insurance.

Procedures for reimbursement of medical insurance in different places:

To seek medical treatment in a different place, you need to go to an outpatient clinic or hospital and issue receipts, lists, prescriptions, details, medical insurance manuals and case diagnosis certificates for related expenses. At the same time, it is necessary to issue the registration certificate of the hospital where the doctor is located, so that the employer, the social security office and the district/county medical insurance center can make statistical summary and audit settlement.

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