Social security reimbursement process after hospitalization

Hospitalization reimbursement process:

1. When you are admitted to or discharged from the hospital, you must go to the medical insurance management window of each designated medical institution with your medical insurance IC card to go through the registration procedures for entering and leaving the hospital. When you are hospitalized, you have to pay the deposit in advance, and then you have to pay more or less after you are discharged from the hospital.

Medical fees incurred before hospitalization registration are not covered by basic medical insurance. If you are hospitalized due to an emergency and cannot complete the hospitalization registration procedures in time, you should go to the medical insurance management window on the next day after your admission to the hospital with a certificate of emergency to complete the hospitalization procedures (or deferred in case of holidays), and you will be responsible for the medical fees incurred beyond the time limit.

2, hospitalized participants in the integrated fund of the starting line: the starting line of standards vary from place to place is generally 10% of the average annual salary of the city's employees in the previous year, in a basic medical insurance settlement year, multiple hospitalization of the medical costs are calculated cumulatively.

3, the insured person's condition requires referral or transfer to a hospital, must be diagnosed by the deputy chief physician or section chief of a designated medical institution above the third level of referral (hospital) advice, the unit to fill out an application form, the designated medical insurance management department of the medical insurance agency agreed to report to the city (district) social security institutions for approval after the referral (hospital) procedures.

The transfer is limited to the provincial special hospitals, the cost of which is first advanced by the person, and its reimbursement rate should be 10% first, and then calculate the reimbursable amount in accordance with local regulations.

4. When discharged from a designated medical institution, each designated medical institution will calculate the amount of reimbursement and the amount of personal out-of-pocket payment in accordance with the relevant policies; the reimbursement amount will be settled by the designated medical institution and the urban social insurance agency, and the amount of personal out-of-pocket payment will be settled by the designated medical institution and the insured person himself/herself.

Expanded information:

I, social security hospitalization reimbursement conditions

Participants discontinued enjoyment of the health insurance treatment within 60 days (including 60 days) to re-pay the Medical insurance premiums, from the payment of the next month to enjoy the integrated fund to pay treatment; suspension of the enjoyment of more than 60 days to 180 days (including 180 days) to make up for the payment of medical insurance, starting from the month of payment, three months before enjoying the integrated fund to pay treatment.

If the enjoyment of medical insurance benefits is suspended for more than 180 days to make up for the payment of medical insurance premiums, it is regarded as re-enrollment in medical insurance, and the payment time before the interruption will not be counted as the time of continuous payment of premiums.?

The materials and process required for the retroactive payment are:

Please take your Employee's Medical Insurance Handbook or Social Insurance Certificate, social security card, 1-inch registration photo, and a copy of your ID card to the Individual Collection Department of the social security agency.

Second, the reimbursement rate of medical insurance

Improve the level of basic medical insurance and big disease insurance protection for urban and rural residents, the per capita financial subsidy standard of medical insurance for residents increased by 30 yuan, half of which is used for big disease insurance. Reduce and unify the starting line of major disease insurance, the reimbursement rate from 50% to 60%, and further reduce the burden of medical treatment on patients with major diseases and people in difficulty. Strengthening the prevention and treatment of major diseases.

China's cancer-plagued families in the tens of millions, to implement cancer prevention and treatment actions, promote preventive screening, early diagnosis and treatment and scientific research, and strive to alleviate the pain points of people's livelihood. To do a good job of prevention and treatment of common chronic diseases, hypertension, diabetes and other outpatient medication into the medical insurance reimbursement.

Stepping up the implementation and improvement of the policy of direct settlement of cross-provincial medical treatment, as soon as possible, so that patients with medical treatment in a different place can hold a card to see a doctor in all designated hospitals, instant settlement, and effectively facilitating the mobility of the population and the elderly with the migration. Deepen the comprehensive reform of public hospitals. Promote social medical management.

Speeding up the establishment of a telemedicine service system, strengthening the training of grassroots healthcare personnel, and improving the quality of hierarchical diagnosis and treatment and family doctor contracting services. Adhering to the principle of prevention, the new financial subsidies for basic public **** health services will all be used in villages and communities, making sure that the grassroots will benefit. Strengthening maternal and child health care services. Support the development of Chinese medicine inheritance and innovation.

Pharmaceuticals and vaccines are a matter of life and safety, and must be strengthened throughout the supervision, the lawbreakers should be severely punished, dereliction of duty should be seriously investigated and dealt with, and resolutely guard the people's lives and health of the line of defense.

Baidu Encyclopedia - Social Insurance

Baidu Encyclopedia - Social Security Reimbursement

People's Daily Online - Reducing and Unifying the Starting Line of Major Disease Insurance Reimbursement Percentage Increased to 60 Percent

China News Service - Reform of the Social Insurance Premium Levy System Does Not Increase the Burden on Enterprises Overall