Time limit for second reimbursement for serious illness

The time limit for the second reimbursement of serious illness is about half a year.

The time for the second reimbursement of serious illness is limited, generally about half a year. Therefore, the insured should pay attention to this time, so as not to miss the time for reimbursement, resulting in failure to reimburse. Residents who participate in the new rural cooperative medical system can pay the expenses within the scope of medical insurance after being reimbursed by normal medical insurance. Residents' income in the previous year has exceeded the per capita disposable income in the previous year, and the excess can be reimbursed. If the excess is less than 50 thousand yuan, it can be reimbursed by 50% of the serious illness insurance, and if it exceeds 50 thousand yuan, it can be reimbursed by 60% of the total amount. The specific provisions are as follows:

1. Time limit: the time limit for the second reimbursement for serious illness is generally 6 months, that is, after the occurrence of serious illness, you can apply for the second reimbursement within 6 months from the date of the end of the first reimbursement;

2. Reimbursement ratio: The reimbursement ratio and reimbursement limit of the second reimbursement for serious illness will also vary according to different regions and medical insurance policies. Under normal circumstances, the reimbursement ratio of secondary reimbursement for serious illness will not exceed 90%;

3. Reimbursement process: The process of secondary reimbursement for serious illness is generally to reimburse medical expenses for medical insurance in the hospital first, then wait for medical insurance to settle, and then take the part that has not been reimbursed to the Social Security Bureau for secondary reimbursement.

Materials required for secondary reimbursement of serious illness:

1. Outpatient medical records: it is necessary to provide the medical records, medical records abstracts or diagnosis certificates of this outpatient service to prove that this outpatient service is a serious illness outpatient service;

2. Medical insurance payment voucher: medical insurance payment voucher for this outpatient service is required, including medical insurance card, social security card, outpatient statement and other supporting materials;

3. Outpatient invoice: it is necessary to provide invoices or receipts and other related expense vouchers to prove the actual expenses of this outpatient service;

4. Other materials: According to the requirements of different regions and medical insurance policies, it may be necessary to provide other relevant supporting materials, such as ID card, household registration book, social security payment certificate, etc.

To sum up, different regions and different medical insurance policies may have different provisions. Please refer to local policies for specific materials. At the same time, when applying for the second reimbursement of serious illness, the parties concerned shall submit the application materials in accordance with the prescribed procedures and receive the reimbursement at the designated place at the specified time.

Legal basis:

Article 20 of the Labor Law of People's Republic of China (PRC)

The state develops social insurance, establishes social insurance system and social insurance fund, so that workers can get help and compensation in old age, illness, work injury, unemployment and childbirth.