What is the difference between the three types of social security personnel?

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Brief introduction of online settlement of medical expenses of "three types of medical insurance" personnel

According to Shanghai Medical Insurance [2007] 169 "On Printing and Distributing; Notice, starting from this year's 10 and 18, three groups of people (hereinafter referred to as "three types of medical insurance") will be added, and they can take social security cards (or medical insurance cards) for medical treatment and online settlement. The main policies are:

I. Applicable objects and guaranteed benefits:

1. Elderly survivors: emergency and hospitalization 50%;

2. Unsecured elderly: 50% for outpatient and emergency services and 70% for hospitalization;

3. Severely disabled people: 50% in emergency and 70% in hospital;

The scope of reimbursement for the "three types of medical insurance" personnel shall be implemented with reference to the relevant provisions of the basic medical insurance for urban workers in this Municipality, and the method of self-sufficiency shall not be implemented.

Second, the medical certificate:

1. Emergency: social security cards (or medical insurance cards) and medical records are issued and used simultaneously.

2. Hospitalization: Social security cards (or medical insurance cards) need to be issued and used.

Third, medical management:

1. Outpatient service:

(1) Implement the designated medical treatment and referral system. Insured persons can seek medical treatment in a first-class hospital. Because of illness and diagnosis and treatment need referral, referral procedures should be handled in a hospital, referral to the city's two or three hospitals; If you need to be referred again, you can go through the referral procedures in the secondary and tertiary hospitals and refer to the designated medical insurance designated hospitals for medical treatment. The maximum number of referral medical institutions is 1 unit, and the referral period is 3 months.

(2) For the insured who need to be referred, the certificate of changing one's major in outpatient service shall be issued by the attending physician and filled in item by item, which shall be audited and stamped by the outpatient reception room and registered by credit card.

2. Emergency:

If designated medical care is not implemented, the expenses incurred shall be paid according to the regulations.

be hospitalized

Do not implement designated medical care. The insured can be hospitalized in the designated medical institutions of medical insurance in this Municipality (including emergency observation room), and the expenses incurred shall be paid according to the regulations. (Medical Insurance Office)