Shenzhen children's medical insurance binding social health

There are several ways to bind children's medical insurance to Dukang Hospital: it can be directly bound to hospitals or social health centers; You can also log on to the website of the local social security bureau, enter the declaration system for children and college students, and then select the name of the hospital to bind and bind it. Or bring your ID card and social security card to the self-service terminal of the social security institution and bind them according to the prompt.

Legal objectivity:

Children's medical insurance is a guarantee for medical expenses such as hospitalization, treatment and surgery caused by certain diseases reported by insurance. At present, China's basic medical system basically has a very low level of medical security for children. It is suggested that we can consider referring to some commercial security to reduce family risks. 1. How to handle Shenzhen Children's Medical Insurance Binding Hospital? If in September, an insured child pays the fee successfully, and the parents are bound to a nearby community health center or hospital, then this month, if the insured child goes to the bound community health center or hospital to see the general outpatient service, he can be reimbursed for the fee. The person in charge reminded that after the children's medical insurance is included in the hospitalization medical insurance, the time to enjoy the treatment will be subject to the provisions of the hospitalization medical insurance, and they will enjoy the medical insurance treatment from the month after the medical insurance premium is paid in full, instead of enjoying the treatment in the same month as before. /kloc-for children under 0/4 years old, the clinic can choose to bind the community health center, or choose to bind the outpatient treatment of the second-class and below hospitals in the city; /kloc-The physical development of children over 0/4 years old is relatively perfect, and the incidence rate is similar to that of adults. They receive the same treatment as the adult insured in the binding social rehabilitation center. The Municipal Social Security Bureau called on and mobilized enterprises and individuals to go through the binding procedures as soon as possible to avoid the "invalidation" of general outpatient treatment. Second, why should hospitalization be bound to community health centers? Why should we bind the community health center to enjoy outpatient treatment? According to the person in charge of the Municipal Social Security Bureau, when the outpatient treatment of the insured is increased, the payment will not be increased, and the original hospitalization treatment will not be affected. Instead, the 6 yuan will be set aside from the original payment of each insured as the outpatient co-ordination fund. "6 yuan money per person is quite small. In order to maintain the balance of the outpatient co-ordination fund, it is necessary to bind a community health center, and the social security agency will pay the outpatient expenses to the community health center in one lump sum according to the number of participants bound by the community health center, and pay the outpatient expenses of the insured with limited money. " The person in charge said. Three ways to participate in the binding At present, children under the age of 14 can choose three ways to bind: those who are insured for the first time can choose the community health center or hospital near their place of residence when submitting the insurance information; Log on to the website of Shenzhen Social Security Bureau and choose the community health center or hospital near your residence through the personal online declaration system; Go to the nearest street, community or social security agency for binding. /kloc-children over 0/4 years old can also choose three binding methods: 1, and bind directly to the social rehabilitation center for binding; 2. Log on to the website of Shenzhen Social Security Bureau and bind the social health center for outpatient treatment through the personal online declaration system; 3. When the insured person submits the insured information for the first time, he can choose to bind the outpatient service for medical treatment. After the insured children are bound to the designated medical institutions for outpatient treatment, the community health center or hospital outpatient treatment shall not be changed within 1 month. But after 1 month, you can choose to bind a new community health center or hospital again. Third, how to reimburse the inpatient medical outpatient expenses? Article 43 of the "Current Measures for Social Medical Insurance in Shenzhen" stipulates that the outpatient (including emergency) expenses incurred by the insured in the selected community health centers shall be handled in accordance with the following provisions: (1) Those drugs that belong to Class A drugs and Class B drugs in the basic medical insurance drug list shall be paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; (two) belong to the basic medical insurance directory of medical items or medical materials, a single price below 120 yuan, paid by the community outpatient co-ordination fund 90%; If the single price exceeds 120 yuan, the community outpatient co-ordination fund will pay 120 yuan; (III) The outpatient medical expenses incurred by the insured who need to be referred to other designated medical institutions with the approval of the settlement hospital due to illness, or the emergency medical expenses incurred in non-settlement hospitals, shall be reimbursed by the community outpatient co-ordination fund according to the provisions in the first and second paragraphs of this article. The person in charge also reminded that emergency expenses can be paid in advance and then reimbursed in proportion to the bound community health center. If the community health center cannot report, it can be reimbursed to the settlement hospital affiliated to the community health center. Tips: The total outpatient medical expenses paid by the community outpatient co-ordination fund to each inpatient medical insurance participant in a medical insurance year shall not exceed 800 yuan, including emergency expenses in 800 yuan. Second, why should hospitalization be bound to community health centers? Why should we bind the community health center to enjoy outpatient treatment? According to the person in charge of the Municipal Social Security Bureau, when the outpatient treatment of the insured is increased, the payment will not be increased, and the original hospitalization treatment will not be affected. Instead, the 6 yuan will be set aside from the original payment of each insured as the outpatient co-ordination fund. "6 yuan money per person is quite small. In order to maintain the balance of the outpatient co-ordination fund, it is necessary to bind a community health center, and the social security agency will pay the outpatient expenses to the community health center in one lump sum according to the number of participants bound by the community health center, and pay the outpatient expenses of the insured with limited money. " The person in charge said. Three ways to participate in the binding At present, children under the age of 14 can choose three ways to bind: those who are insured for the first time can choose the community health center or hospital near their place of residence when submitting the insurance information; Log on to the website of Shenzhen Social Security Bureau and choose the community health center or hospital near your residence through the personal online declaration system; Go to the nearest street, community or social security agency for binding. /kloc-children over 0/4 years old can also choose three binding methods: 1, and bind directly to the social rehabilitation center for binding; 2. Log on to the website of Shenzhen Social Security Bureau and bind the social health center for outpatient treatment through the personal online declaration system; 3. When the insured person submits the insured information for the first time, he can choose to bind the outpatient service for medical treatment. After the insured children are bound to the designated medical institutions for outpatient treatment, the community health center or hospital outpatient treatment shall not be changed within 1 month. But after 1 month, you can choose to bind a new community health center or hospital again. Third, how to reimburse the inpatient medical outpatient expenses? Article 43 of the "Current Measures for Social Medical Insurance in Shenzhen" stipulates that the outpatient (including emergency) expenses incurred by the insured in the selected community health centers shall be handled in accordance with the following provisions: (1) Those drugs that belong to Class A drugs and Class B drugs in the basic medical insurance drug list shall be paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; (two) belong to the basic medical insurance directory of medical items or medical materials, a single price below 120 yuan, paid by the community outpatient co-ordination fund 90%; If the single price exceeds 120 yuan, the community outpatient co-ordination fund will pay 120 yuan; (III) The outpatient medical expenses incurred by the insured who need to be referred to other designated medical institutions with the approval of the settlement hospital due to illness, or the emergency medical expenses incurred in non-settlement hospitals, shall be reimbursed by the community outpatient co-ordination fund according to the provisions in the first and second paragraphs of this article. The person in charge also reminded that emergency expenses can be paid in advance and then reimbursed in proportion to the bound community health center. If the community health center cannot report, it can be reimbursed to the settlement hospital affiliated to the community health center. Tips: The total outpatient medical expenses paid by the community outpatient co-ordination fund to each inpatient medical insurance participant in a medical insurance year shall not exceed 800 yuan, including emergency expenses in 800 yuan. Three ways to participate in the binding At present, children under the age of 14 can choose three ways to bind: those who are insured for the first time can choose the community health center or hospital near their place of residence when submitting the insurance information; Log on to the website of Shenzhen Social Security Bureau and choose the community health center or hospital near your residence through the personal online declaration system; Go to the nearest street, community or social security agency for binding. /kloc-children over 0/4 years old can also choose three binding methods: 1, and bind directly to the social rehabilitation center for binding; 2. Log on to the website of Shenzhen Social Security Bureau and bind the social health center for outpatient treatment through the personal online declaration system; 3. When the insured person submits the insured information for the first time, he can choose to bind the outpatient service for medical treatment. After the insured children are bound to the designated medical institutions for outpatient treatment, the community health center or hospital outpatient treatment shall not be changed within 1 month. But after 1 month, you can choose to bind a new community health center or hospital again. Third, how to reimburse the inpatient medical outpatient expenses? Article 43 of the "Current Measures for Social Medical Insurance in Shenzhen" stipulates that the outpatient (including emergency) expenses incurred by the insured in the selected community health centers shall be handled in accordance with the following provisions: (1) Those drugs that belong to Class A drugs and Class B drugs in the basic medical insurance drug list shall be paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; (two) belong to the basic medical insurance directory of medical items or medical materials, a single price below 120 yuan, paid by the community outpatient co-ordination fund 90%; If the single price exceeds 120 yuan, the community outpatient co-ordination fund will pay 120 yuan; (III) The outpatient medical expenses incurred by the insured who need to be referred to other designated medical institutions with the approval of the settlement hospital due to illness, or the emergency medical expenses incurred in non-settlement hospitals, shall be reimbursed by the community outpatient co-ordination fund according to the provisions in the first and second paragraphs of this article. The person in charge also reminded that emergency expenses can be paid in advance and then reimbursed in proportion to the bound community health center. If the community health center cannot report, it can be reimbursed to the settlement hospital affiliated to the community health center. Tips: The total outpatient medical expenses paid by the community outpatient co-ordination fund to each inpatient medical insurance participant in a medical insurance year shall not exceed 800 yuan, including emergency expenses in 800 yuan.