How to deal with neonatal medical insurance in Nanjing

The handling process of neonatal medical insurance in Nanjing is as follows:

1, the newborn settled down. Bring your ID card, household registration book and birth certificate to the place where your household registration is located for the newborn to settle down. (Some places need to write an application);

2. Participate in insurance. Bring birth certificate and household registration book to the street office or social security agency for registration. (Note, even if you have a social security card without registration, you can't pay it);

3. Submit an application. Bring birth certificate, identity certificate, household registration book and other materials to the local social security agency to handle the social security card procedures, and submit various materials as required;

4, the social security department for review. After receiving all the information, the staff will review the information and feedback the results to the applicant in time;

5. Make a social security card. For those who meet the requirements, the staff will make social security cards in time according to the corresponding processes;

6. Get a social security card. After handling the card, they will notify the applicant by SMS or telephone to collect it within the legal time;

7. Pay by mobile phone. Parents can pay for baby medical insurance on their mobile phones.

Medical insurance reimbursement process:

1. Under normal circumstances, when you need to be hospitalized due to illness, you can go to your designated hospital with your medical insurance card and medical records, and settle with your medical insurance card. That is, some of them are paid by themselves, and some medical insurance centers and hospitals reimburse and settle accounts;

2 from designated hospitals to secondary or tertiary hospitals, medical insurance cards can be used for settlement;

3. The patient is critically ill and hospitalized in a non-designated hospital. He should go to the municipal medical insurance center for emergency rescue disease identification within 5 days. After being identified as an emergency rescue disease, he can use the medical insurance card for settlement in the rescue hospital;

4, transferred to other places for treatment, with the consent of the hospital and medical insurance center, the referral procedures. The expenses incurred in the field shall be settled by the individual at his own expense, and after the diagnosis and treatment, the community labor security workstation shall prepare the materials for reimbursement;

5, medical insurance reimbursement is calculated in proportion, generally ranging from 70%. The proportion and amount of reimbursement are related to factors such as self-examination, medication and medical grade;

6. At the time of reimbursement, the insured person needs to prepare relevant materials for hospitalization, such as outpatient medical records, discharge records, discharge diagnosis (disease diagnosis), hospitalization invoices (which can be reported to the outpatient department), general list of hospitalization expenses, and medical insurance statements. If the hospital has done CT, B-ultrasound, electrocardiogram and other inspections, it is also necessary to prepare relevant inspection reports;

7, discharge settlement, submit relevant information, in the medical insurance reimbursement window can be reimbursed. After approval, the reimbursement amount will generally arrive within 15 working days.

To sum up, when the newborn is insured, parents should first register the newborn and obtain the ID number. When handling medical insurance, bring my household registration book (copy of the first page and copy of the child's household registration page), parents' ID card (copy of both sides) and one-inch photo of the newborn with blue or red background to the street or community labor security office where the household registration is located to handle the insurance procedures. It takes more than a month from going through the insurance formalities to getting the newborn medical insurance card. Generally speaking, any newborn born within 12 months can be insured at any time.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.