How to use medical insurance card when hospitalized

Medicare card can be used for daily purchase of medicines, outpatient emergency and hospitalization reimbursement, then how to use the medical insurance during hospitalization? After hospitalization medical insurance card and how to reimburse it? Below by the understanding of the vision of the editor for you to organize the hospitalization when the use of medical insurance card code, I hope you like it!

How to use the medical insurance card when hospitalized

How to use the medical insurance card when hospitalized

The prerequisite for the use of the medical insurance card is that you have already participated in the local medical insurance and have been enrolled in the last month of the payment record. Consumers who meet these two requirements can use their card if they are hospitalized. So how do you use a hospitalization card? You can refer to the following procedure

1. The participant first goes to the local designated hospital, and after diagnosis by the doctor, an admission notice is issued

2. Bring the admission notice, the local social security card or employee social insurance card, and go to the hospital's inpatient billing office to complete the charging procedures

3. After recovering from the illness, the participant is discharged from the hospital with the social security card or employee social insurance card, and the charges are checked. Check the hospitalization charges and settle the bill.

The above three steps are the process of using the medical insurance card when you are hospitalized. Then for hospitalization, how to reimburse the medical insurance card? You can refer to the following process.

Medicare card reimbursement

1. When you are hospitalized, please fill in the hospitalization registration form and return it to the charging office

2. With the discharge notification form for the settlement of accounts

3. Bring the hospital invoice, discharge card, cost list, medical card and ID card to the local social security bureau to make reimbursement.

Medical insurance hospitalization reimbursement rate

As for how much the medical insurance can reimburse after hospitalization, it depends on the local specifics. In Shanghai, for example, the reimbursement rate for residents' hospitalization medical insurance is as follows:

1. The medical expenses incurred by in-service employees who are hospitalized in the hospital or hospitalized in the emergency observation room that are paid by the coordinated fund are subject to a starting standard of 1,500 yuan.

2. 85% of the medical expenses incurred by an active employee for hospitalization or emergency observation room observation within a medical insurance year shall be paid by the coordinated fund for the portion of the accumulated medical expenses exceeding the starting payment standard.

3. Medical expenses incurred by an active employee that are below the starting payment standard and the remaining part of the medical expenses after they have been paid by the coordinated fund shall be paid by the balance of the individual medical account for the previous years, and the active employee shall be responsible for the shortfall.

4. For medical expenses above the starting payment standard incurred by an employee for hospitalization and hospital observation in the emergency observation room, as well as medical expenses for outpatient major illnesses and family hospital beds within a medical insurance year, the portion of the medical expenses that cumulatively exceeds the maximum payment limit of the co-ordinated fund (390,000 yuan) shall be paid for by 80% from the supplementary fund, and the remaining portion shall be borne by the employee.

Frequently asked questions about the use of health insurance cards

If you have a serious illness and need to be hospitalized

If you have a serious illness and need to be hospitalized, it's okay if you give your card to the hospital, you can be assured of the treatment, and it doesn't matter if you don't have a penny in your card; when you are discharged from the hospital, the hospital will settle the bill with the health insurance center, and the individual only needs to bear one-third of the cost.

Outpatient expenses exceeding 1,500 yuan can be reimbursed

What if you go to an outpatient clinic? Then you need to use your card balance to pay for the outpatient expenses. What if you run out of card balance? You'll have to pay for it out of your own pocket.

Note: When the out-of-pocket expenses exceed $1200, the excess is reimbursed at a rate of 60%. The out-of-pocket portion is cumulative, and once it reaches $1,500 per year, the excess is reimbursed on a sliding scale.

But there is a limit to the amount that can be reimbursed, only in the individual payment and reimbursement of the total amount of 2000, more than part of the subsidy will no longer be given, of course, this 2000 refers to the accumulation of 1500 after ah, not including 1500.

As an example, if you spend 2300 yuan on outpatient care, the excess 800 yuan can be reimbursed 480 yuan, and the individual will only bear 320 yuan, the hospital and the health insurance center to settle the bill directly, you do not have to worry about this.

Need to transfer from the community hospital to be reimbursed?

China's health insurance for? urban elderly? and? unemployed residents? The community-based primary care system is in place. If you want to see a doctor, you have to go to the community first, and the reimbursement rate in the community is relatively higher than that in large hospitals. If the illness is an emergency, it is not subject to the first-visit system, and hospitalization does not require a first-visit. All others must go to the community first.

Therefore, the ? urban elderly? and? unemployed residents? to be sure to go to the community hospital before going to the big hospitals to see a transfer, otherwise spend tens of thousands of medical bills are not reimbursed.

Reminder: from the community to the big hospital, but also need to community hospitals to issue the relevant referral certificate, in order to see the big hospital to enjoy the health insurance reimbursement. Referral procedures are very simple, to the nearest community hospital registration office to give the card to the registration of the person said to transfer so-and-so hospital can be.

The new rural cooperative? The villagers have to go to the county hospital first

New Rural Cooperative villagers? The need to go to the local county hospital first, the reimbursement rate of about 60% to 70%, transferred to the municipal hospital diagnosis can only report about 50% to 60%. The procedures required to transfer to a foreign province are more troublesome, in addition to a number of provinces currently do not have the conditions for mutual transfer.

Additionally, going to a specialized hospital is not subject to the first-visit system, such as cerebral hospitals, thoracic hospitals, oncology hospitals, stomatology hospitals, etc., because these hospitals are irreplaceable.