How to use the electronic social security card to go to the hospital?

How to use the electronic social security card to go to the hospital is as follows:

1. When entering or leaving the hospital, you must go through the registration formalities with the medical insurance IC card at the medical insurance management window of each designated medical institution. When in hospital, pay the hospitalization deposit in the inpatient department with the identity certificate and the doctor's admission arrangement. After arriving in the ward, take the medical insurance card to the service desk, and let the hospital reimburse all the expenses such as drugs and equipment that cannot be reimbursed during the examination and treatment, so that you can pay in the outpatient department, just like the uninsured, and settle in cash. When the hospitalization deposit is not enough, it must be renewed;

2. After the insured is hospitalized, the deductible line of the overall fund is divided into three grades: tertiary hospital 1000 yuan, secondary hospital 600 yuan, and primary hospital 400 yuan. In a basic medical insurance settlement year, the cumulative calculation of medical expenses for multiple hospitalizations;

3, the insured due to illness need referral (hospitalization), shall be approved by the designated medical institutions (three or more) deputy chief physician or chief physician diagnosis put forward referral (hospitalization) opinions, by the unit to fill in the application form, after the approval of the designated medical institutions medical insurance management department reported to the municipal (District) social security institutions for referral (hospitalization) procedures. Then go through the discharge formalities, the inpatient department will issue a list of expenses after checking out, and take this list and the materials copied in the ward to the medical insurance center. After preliminary examination, if the materials are incomplete, they will be returned as soon as possible. Then, tell you to get the audit notice after 5 working days;

4. When the designated medical institutions are discharged from the hospital, the reimbursement amount and the amount payable by individuals shall be calculated by the designated medical institutions, and the reimbursement amount shall be settled by the designated medical institutions and urban social insurance agencies, and the amount payable by individuals shall be settled by the designated medical institutions and the insured.

5. When visiting a designated hospital, show the medical insurance card to prove the identity and registration of the insured. Individuals do not need to pay first and then reimburse, and the part of medical insurance reimbursement can be directly settled by medical insurance and hospitals. Only when the account is settled, the self-funded part will be paid by the balance of the medical insurance card or cash. As a result, after three working days, I received a call from the medical insurance center. After I got the bill, I went to the inpatient department to check out again, deducted the reimbursement from the original hospitalization deposit and returned it to the inpatient department together with the balance of hospitalization expenses. This is the end of hospitalization reimbursement.

legal ground

Article 25 of the Social Insurance Law

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 26

The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations;

Article 27

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state;

Article 28

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

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.