Hua county social security Chang medical reimbursement

The condition needs to be transferred to other places.

Responsible for the certificate issued by the hospital

If the patient needs to be transferred to other places for hospitalization due to illness, the transfer hospital should be the designated referral hospital.

Examination and approval procedures: the insured or the client shall go through the registration procedures of hospitalization in different places with the Registration Form for Referral and Referral of Tianjin Basic Medical Insurance and other registration materials filled out by the responsible hospital for referral and referral, and can only be transferred to other medical institutions designated by the Administrative Measures for Referral and Referral for Medical Treatment after the consent of the social security agency. If it is really necessary to transfer to a non-designated nonlocal medical institution for medical treatment, it must be approved by the municipal labor and social security administrative department before it can be transferred to a nonlocal medical institution for medical treatment. If the insured person needs to be transferred to other places for hospitalization due to treatment, and the emergency observation is transferred, it shall be implemented with reference to the relevant provisions of the basic medical insurance for urban workers in this Municipality.

Settlement method: ① If the insured person is referred to a foreign medical institution for treatment after going through the referral registration formalities, the medical expenses incurred within the reimbursement scope of the basic medical insurance for urban and rural residents in Tianjin will be reimbursed. ② If the unit price of medical service items is higher than that of Tianjin basic medical insurance reimbursement items, they shall be reimbursed according to the price of Tianjin basic medical insurance reimbursement items; If the unit price is lower than the reimbursement item price of Tianjin basic medical insurance, it shall be reimbursed according to the actual price. (III) Drugs whose generic name is in the Catalogue of Drugs for Basic Medical Insurance in Tianjin and whose drug approval number is not in the thesaurus shall be reimbursed with reference to the prices of similar drugs in the thesaurus of this Municipality. When the drug price is higher than the price of similar drugs in the different-name library, it shall be reviewed and reimbursed according to the highest price of similar drugs in the different-name library; If it is lower than the highest price of similar drugs in different name libraries, it shall be audited and reimbursed according to the actual price.

Convenience measures: In order to meet the medical needs of insured urban and rural residents in remote areas of this city, wuqing district People's Hospital, Baodi District People's Hospital, Ninghe County Hospital, Jinghai County Hospital, Jixian County People's Hospital and Hangu District Hospital will be included in the designated referral hospitals for medical insurance this year. If the insured urban and rural residents in Laowu County and Hangu District go to Beijing medical institutions other than Peking Union Medical College Hospital, Fuwai Hospital and Friendship Hospital for medical treatment, they can go directly to the district and county new rural cooperative medical service centers for referral examination and approval procedures; The new rural cooperative medical service center will report the referral approval to the Municipal Human Resources and Social Security Bureau for the record every month. The medical expenses incurred by the insured urban and rural residents in line with the scope of reimbursement of the basic medical insurance in this Municipality shall be borne by the insured patients for 5% of the expenses, and the rest shall be reimbursed by the basic medical insurance fund for urban and rural residents according to the regulations.

Two:

If you live in a foreign country, you need to see a doctor.

The place of insurance shall be put on record.

The relevant person in charge of the Municipal Social Security Center said that if the insured person goes out temporarily and is hospitalized in an emergency in a different place, it shall be implemented with reference to the relevant regulations on the management of medical treatment in different places in the basic medical insurance for urban employees. Insured persons with local household registration living in other places need medical treatment. They can choose a local first-,second-,third-class hospital and a specialized hospital, and register at the place where the insurance payment is made, and the social security agency at the place where the insurance payment is made will fill in the Registration Form for Resettlement Personnel of Basic Medical Insurance for Urban and Rural Residents in Tianjin for filing. Pay the medical expenses that meet the requirements in the filing hospital.

Three:

Children leave the emergency.

Reimbursement according to the city standard.

The medical expenses incurred by insured students and children during their temporary outing (referring to emergency hospitalization in different places) can be paid according to the scope and standard of reimbursement stipulated by the basic medical insurance for urban and rural residents in Tianjin. For students and children who are enrolled in the city's household registration in other places, they shall register for resettlement in different places in accordance with the provisions of the Measures for the Administration of Medical Treatment in Different Places in Tianjin's Basic Medical Insurance for Urban Employees. The insured person chooses local first-,second-and third-class hospitals 1 home, and the social security agency where the insured payment is made shall fill in the Registration Form for Relocated Persons of Tianjin Urban and Rural Residents' Basic Medical Insurance for the record. Pay the medical expenses that meet the requirements in the filing hospital.

The hospitalization expenses incurred by insured foreign students and their children during their study in this city should be reported to the social security agency for reimbursement within one month after returning to school after medical treatment.