2022 Shijiazhuang chronic disease reimbursement policy

Outpatient chronic disease medical fee starting line 200 yuan, a variety of chronic diseases within the year does not repeat the calculation of the starting line, more than the starting line occurs within the policy scope of the medical costs of the disease, the individual bear 40%, the coordinated fund bear 60%. The outpatient chronic diseases implement the management of single disease annual payment limit, the annual expenditure of the integrated fund of a single chronic disease does not exceed the annual payment limit of the disease. Provincial level 4% supplemental medical insurance participants outpatient chronic disease treatment by the 4% supplemental insurance fund to pay, outpatient chronic disease costs and hospitalization medical costs are not combined to calculate the annual maximum payment limit of the basic medical insurance fund.

I. The conditions for reimbursement of medical insurance are:

1. To the designated medical institutions of the cooperative medical care: the general outpatient and emergency expenses incurred by the participants in the medical insurance designated hospitals or specialized hospitals of their choice, Chinese medicine hospitals and Class A hospitals.

2. Prepare original invoices: general outpatient, emergency expenses paid in cash by the individual, resulting in medical expenses to be within the scope of the three major catalogs of medical insurance library.

3, bring the medical insurance card and my ID card: 1-20 days a month, the month's expenses will be declared in the following month, the current year's expenses will be applied for reimbursement before January 20 of the following year.

4. The participant will submit the documents to the unit or social security office, which will enter the documents into the enterprise version, and then declare the electronic information and documents to the health insurance center.

Second, the medical insurance reimbursement required materials:

1, the original receipt;

2, hospitalization expense statement;

3, discharge diagnosis certificate;

4, stay in observation certificate or a copy of the death certificate.

Legal Basis: The Social Insurance Law of the People's Republic of China

Article 2: The State establishes a social insurance system for basic old-age pension insurance, basic medical insurance, industrial injury insurance, unemployment insurance, and maternity insurance, and guarantees the right of citizens to receive material assistance from the State and society in the event of old age, sickness, industrial injury, unemployment, or maternity in accordance with law. The right to receive material assistance from the State and society in old age, sickness, industrial injury, unemployment and childbirth.

Article 26 The standards of treatment for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be carried out in accordance with the provisions of the State.

Article 28 Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as emergency and rescue medical expenses shall be paid out of the basic medical insurance fund in accordance with the state regulations.