How to reimburse Hainan medical insurance in foreign provinces

A, foreign province medical insurance reimbursement process foreign medical insurance reimbursement process is as follows: (a) in the insured place for the record, you want to enjoy the cross-provincial medical insurance reimbursement must be in the first place in the insured place of the health insurance agency for the record, in the record need to be written clearly for the record reason as well as the location of the medical treatment. If you have been living in a different place for more than half a year, you can make a long-term record of medical treatment in a different place. If you need to change your province of permanent residence, you can make another record. If you do not live in a foreign place for a long time and need to seek medical treatment in a foreign place, you can make a short-term filing, but there is a short-term filing that is only valid for the current time, and can be processed several times. Travel in a different place, visit relatives during the sudden illness, need to be in a foreign province in the medical care of the insured, can be emergency filing, but must submit a copy of the admission to the individual health insurance location of the health insurance agency. (ii) Registering for medical treatment at the registered hospitals for the record. When the insured person applies for the record of cross-provincial medical treatment, he/she can choose three designated hospitals, and the insured person can choose the hospitals he/she will visit among these three designated hospitals. (iii) Registration for hospitalization with social security card, the insured person will go to the designated hospital with social security card to register for hospitalization, and after being discharged from the hospital, he/she can use his/her medical insurance card to reimburse the medical expenses at the hospital's off-site settlement window. Second, the process of medical treatment in other places (a) transfer process 1, the insured person should register at the local office of the insured place before seeking medical treatment in other places across the province. 2, the local office of the insured place should handle the filing procedures of medical treatment in other places for the insured person according to the local regulations and establish a database of the persons who have filed the record of medical treatment in other places and realize dynamic management. 3, the local office of the insured place will report the information of the persons who have sought medical treatment in other places to the Ministry of Human Resources and Social Security Social Security Agency (hereinafter referred to as the ministry-level office). (hereinafter referred to as the ministerial-level agency), forming a national database of persons filing for medical treatment in other places, which is available to the agency in the place of medical treatment and the designated medical institutions for obtaining information of the insured persons for medical treatment in other places. (II) Settlement Process When the insured person is discharged from the hospital for settlement of medical treatment in a different place, the agency in the place of medical treatment will, according to the nationally standardized list of major types of expenses, transmit the information on the hospitalization medical expenses of the insured person through the national settlement system for medical treatment in a different place to the agency in the place of medical treatment in a real-time manner. Third, the health insurance reimbursement ratio (a) the city health insurance reimbursement ratio of first-class hospitals 92% second-class hospitals 90% third-class hospitals 85% aged 50 years old increased by 2% aged 60 years old increased by 4% example of 60 years old 89% (third-class) aged 70 years old increased by 6% aged 80 years old increased by 8% the same incremental increase, not exceeding 100% (b) the urban and rural residents of the health insurance reimbursement ratio grade payment health center first-class second-class third-class first-class 10065%60%55%35%Second grade 20090%80%65%50%Third grade 30090%85%80%65%Students12090%80%65%50% (c) Provincial health insurance reimbursement ratio in the payment ratio formula (age * 0.2 + 75) ÷ 100 based on the age of 50-59 years old increased by 2%60-69 years old increased by 4%Example of the age of 60 years old 87% + 4% = 91% 70-79 years old increased by 6% 80-89 years old increased by 8% of the same incremental, not more than 100% from the above content can be known, in the case of medical treatment occurs in a different place, we can be based on the rules of medical insurance reimbursement of a different place to carry out the reimbursement procedures in accordance with the maximization of the degree of can reduce expenditure, and at the same time, to timely consultation of the local health insurance policy and preferential policies.

Article 28 of the Social Insurance Law conforms to the basic medical insurance drug directory, diagnostic and treatment items, medical service facility standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund. Article 29 The portion of a participant's medical expenses that should be paid out of the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.