The scope of serious and special diseases in Beijing medical insurance

The scope of medical insurance reimbursement is different in different cities. In social security, medical insurance reimbursement is not classified according to diseases, but according to the amount of reimbursement limited by medical insurance and whether drugs are imported or not, so any disease is meaningless. For example, the local medical insurance only reported hospitalization expenses of 20,000 yuan, and no matter what illness, it is impossible to exceed this amount.

The premise of handling medical insurance for special diseases is that I have participated in medical insurance for urban workers. According to the Notice of Chongqing Municipality on the Interim Measures for Individuals to Participate in Municipal Overall Planning of Medical Insurance for Employees in Chongqing (Yu Fu Fa [2009] No.29), medical insurance is divided into two grades. 20 10， 1， 1，65438，65438，65438， 1，65438，65438，65438，65438，65438，65438，65438， 1，65438，65438，65438，65438，65438，65438，65438

After enjoying the medical insurance benefits, applicants with special diseases will go to the medical insurance sub-center to fill in the declaration form of special diseases with 2 photos of ID card 1 inch and 1 piece from the date of 1 month, and then go to the relevant hospital for physical examination at the end of the month to review the declaration conditions of special diseases.

Those who participate in the cooperative medical insurance for urban and rural residents can also enjoy special disease clinics: hypertension, coronary heart disease, diabetes, malignant tumor, sequelae of cerebrovascular accident, psychosis, cirrhosis, systemic lupus erythematosus, aplastic anemia, tuberculosis, etc. diagnosed by secondary and above medical institutions 10.

Please apply for medical insurance for urban workers at each district medical insurance sub-center or district urban-rural cooperative medical insurance management center, and then apply for medical insurance for special diseases in accordance with the above provisions.

Insured persons who need outpatient medical treatment due to serious diseases shall register with the neighboring county medical insurance center or street (town) medical insurance service point (hereinafter referred to as the service point) (medical insurance personnel shall go to the designated county medical insurance center or service point, the same below). After registration, you can enjoy outpatient medical insurance for serious illness. When handling outpatient medical registration for serious and serious diseases, you should bring the Application Form for Outpatient Medical Registration and the Shanghai Social Security Card (hereinafter referred to as the social security card) or social security card (for medical insurance only) issued by designated medical institutions within the scope specified by the Municipal Medical Insurance Bureau. The insured may entrust others to handle it on his behalf. The client shall carry valid certificates of himself and the insured (such as ID card, household registration book, etc.). ) when dealing with it.

Due to different treatment items, patients with serious illness can choose the corresponding serious illness outpatient medical institutions for treatment according to regulations (medical insurance personnel are selected from the first-class and second-class serious illness outpatient medical institutions within the designated districts and counties), and the related treatment of malignant tumors is limited to two medical institutions, and the same treatment item is limited to 1 designated medical institutions. If the insured person needs to change the designated medical institution within the validity period of registration, he should bring the social security card or medical insurance card and valid documents (such as ID card and residence booklet) to the original county medical insurance center or service point to apply for cancellation of the original outpatient serious illness registration, and then re-register according to the above provisions.