20 17 Newborn Medical Insurance Reimbursement Policy

20 17 neonatal medical insurance settlement policy. If a child participates in medical insurance and falls ill unexpectedly, the liquidation of medical insurance can greatly reduce the financial burden of the family. Next, let's investigate the latest liquidation policy of 20 17 neonatal medical insurance with Bian Xiao.

Neonatal liquidation

The proportion of neonatal medical settlement varies from place to place, and the proportion of neonatal medical insurance in different cities is also different. You can call the local social security bureau at 12333 for free consultation.

Take a city as an example.

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1. General outpatient service: the annual settlement unit is 40% of outpatient service fees below 300 yuan, that is, the maximum 120 yuan/year. Once the settlement is completed, the above expenses in 300 yuan need to be paid by individuals.

2. Serious illness outpatient service: hemophilia, aplastic anemia, systemic lupus erythematosus and other diseases, the fund has no payment limit, and the medical insurance fund pays 75%.

3. Hospitalization: According to the level of medical institutions, the payment standard and fund payment ratio are formulated. Take a tertiary hospital as an example, the standard is above 500 yuan, and the proportion of fund payment is 80%.

Materials required for liquidation

1. If there are no specific diagnosis and treatment items and drug items (including unit price and quantity) or incomplete items on the original outpatient invoice, a complete list of outpatient medical expenses shall be provided.

2, the original invoice hospitalization medical expenses summary list discharge summary or record (midway accounting provides stage summary, the deceased provides death summary or record)

Step 3 make sure

4. The local savings card or debit card marked UnionPay of the applicant himself or his agent (except CITIC, Minsheng, China Merchants Bank and credit card).

5. If the applicant does not handle it himself, the original and photocopy of the ID card of the handler shall be provided.

6. If the name on the receipt is the mother's or father's name, followed by the name of the son or woman, the original and photocopy of the birth certificate must be provided (the original birth certificate must be filled with the name of the newborn before copying).

7. The name on the receipt is not the name of the insured newborn, nor the name of the mother and father, but the name of the son and daughter. It must be changed in the hospital, and the names of vouchers such as expense list and discharge summary stamped by the hospital must be changed at the same time.

8. When the mother is hospitalized, the hospital can issue a receipt and summary list for the newborn separately, but the mother's discharge summary (or record) must be provided.

9. When the medical expenses exceed two companies/medical insurance years, the expense list must be separated by year. For example, if the insured has expenses in both medical insurance years, it must be divided into two summary lists by year: the total expense list from June 15 to June 30.