What are the new rules for the use of medical insurance cards in Beijing?

Medical insurance payment is divided into individual account and overall account. The reimbursement of medical expenses whose base exceeds 1800 yuan shall be paid through the medical insurance pooling account. If the base number does not exceed 1800 yuan, it can be paid by the balance in the personal account in the medical insurance card, that is, the part paid by the individual is the balance entered into the personal account, so that the individual will not pay the medical insurance fee for nothing.

First, the new rules for the use of Beijing medical insurance cards

1, artificial organ reimbursement increased by 50%. The new medical insurance policy introduced this time has adjusted the reimbursement standard for artificial organs, which has increased by 50% on the existing level. The reimbursement scope includes pacemakers, heart valves, intraocular lenses, artificial joints, artificial blood vessels, implantable cardioverter defibrillators and other artificial organs in vivo.

2. Medical insurance has added 1 10 medical items. Another major adjustment is to incorporate 1 10 medical items into the medical insurance plan. These new contents include familiar medical projects.

Second, Beijing medical insurance reimbursement process

1. When holding a social security card for medical treatment, you only need to pay for it yourself, and the reimbursable expenses will be settled by the medical institution and the relevant medical insurance departments. However, if the emergency department doesn't bring the social security card, or because of his special circumstances, he can pay the medical expenses in full, and then when he goes to the hospital next time, he can bring the documents and medical insurance card to the designated window for reimbursement.

2. Outpatient (emergency) consultation: archive card, medical insurance card, medical fee receipt, unified receipt, foreign party, details, and bank statement of Beijing (not left). If you need to seek treatment for trauma, you should provide a description of the cause of trauma and medical records.

3. When the emergency patient is under observation, it is necessary to provide diagnosis certificate, prescription stamped with emergency seal, examination and treatment details, receipt, medical insurance card, archive card and bank statement.

4. Hospitalization expenses should provide hospitalization diagnosis certificate, discharge certificate, real-time settlement statement (full settlement certificate), receipt, details of hospitalization expenses, copy of medical records (stamped with hospital seal), medical insurance card, archive card and bank statement.

5. The diagnosis certificate, discharge certificate, receipt, expense details, medical insurance card, archive card, bank statement, and explanation of reasons for hospitalization in different places are required for the follow-up visit in different places.

From 20211,the maximum payment limit of the fund for outpatient and emergency medical expenses incurred by the participants in the basic medical insurance for urban and rural residents in a medical insurance year was raised from 4,000 yuan to 4,500 yuan. In Beijing, the reimbursement rate of employees exceeds 85%, and that of retirees exceeds 90%, with a maximum of 99. 1% and a maximum of 500,000 yuan.