How to reimburse children for cross-provincial medical insurance?

The medical insurance reimbursement process for children in different places is as follows:

1. Take the patient's ID card or household registration book, two one-inch color photos and the new rural cooperative medical certificate, go through the referral filing procedures, go to the referral hospital for medical treatment, and go through the hospitalization procedures of the new rural cooperative medical system, as long as you find a designated medical institution across provinces for medical treatment.

2, after discharge, with the patient's ID card or residence booklet, the new rural cooperative medical certificate, a copy of medical records, hospitalization statements, hospitalization expenses list, referral filing procedures to the participating institutions for reimbursement.

If only "residents' medical insurance" is purchased, it will be directly reimbursed at the time of discharge settlement. Generally, the reimbursement is more than 60% of the expenses. If you still buy "commercial insurance", bring the discharge settlement invoice, hospitalization medication details, discharge certificate, diagnosis certificate and other materials to contact the corresponding insurance company to reimburse the rest of the expenses. It is very important to pay medical expenses in time and keep the bills for each payment. If it is lost, it will affect the reimbursement.

Materials to be provided for reimbursement of medical insurance in different places: a. Transfer certificate issued by the hospital in this city; B, with the transfer certificate issued by the hospital, go to the social security office (medical insurance office) in this city and district to handle the examination and approval for medical treatment in different places; C, the original hospitalization invoice of the designated hospital in different places, and D, the original list of machine taxi expenses; E. 1 valid copy of hospital medical records (valid hospital seal); F 1 copy of id card.

Or if you go directly to a foreign hospital for hospitalization, you must pay the full amount; If the local hospital can't transfer the diagnosis and treatment, then go to your local medical insurance office for approval and filing, and then go to a foreign hospital for hospitalization. After paying the full fee, you can go back to the local medical insurance for approval and reimbursement. If you haven't left the hospital yet, you can tell the hospital to check out halfway, leave the hospital first, and then go through the above procedures to reimburse the current expenses.

The proportion of medical insurance reimbursement in different places is 1, and the proportion is 70% to 95%. Such as expensive drugs, special examinations and special treatments, 70% will be reimbursed; Class B drugs are counted as 80%; 88% of the threshold fee is more than 3,000 yuan; 3000-5000 yuan is 90%; 5000- 10000 yuan is 92%; 10000 yuan to 95% of the maximum payment limit.

legal ground

People's Republic of China (PRC) social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.