Can Hebei medical insurance be reimbursed across provinces?

Hebei medical insurance can be reimbursed across provinces.

Conditions for handling medical insurance settlement in different places

1. The insured person has gone through the inter-provincial medical registration and filing as required.

2. Hospitals seeking medical treatment in different places have opened a nationwide direct medical treatment in different places.

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3. Have a social security card, complete information, and you can see a doctor.

Who can handle medical insurance settlement in different places?

1. Resident employees in different places: refers to employees assigned by the company to work in different places for a long time. It should be noted here that such people need to live in other places for a long time.

2. Resettlement of retirees in different places: refers to the household registration personnel who have settled in different places with their children and moved into the local area. One thing to note here: employees who have officially received medical insurance in different places apply for record in different places.

3. Long-term residents in different places: refers to those who live in different places for a long time and meet the conditions of the insured place. What needs to be reminded here is that such people need to go through the resettlement filing in the local medical insurance department, be hospitalized in the hospital that is included in the remote medical treatment settlement system, and can directly settle medical expenses with the new social security card.

4. Insured persons who meet the referral conditions of the insured place: generally refers to patients who are hospitalized in different places, hospitalized in emergency, and referred to other hospitals. One thing to note here: it refers to patients who need to go abroad for medical treatment because of their illness and have already issued referral certificates in local hospitals.

Scope of reimbursement for medical insurance drugs

Drugs included in the basic medical insurance payment range are divided into Class A and Class B ... Class A drugs refer to drugs that are basically unified throughout the country and can ensure the basic needs of clinical treatment. The expenses of such drugs shall be included in the payment scope of the basic medical insurance fund and implemented according to the basic medical insurance payment standard.

Quasi-payment.

The basic medical insurance treatment project shall meet the following conditions:

(1) Clinical diagnosis and treatment must be safe and effective, and the cost should be appropriate;

(2) The price department has set the charging standard;

(3) within the scope of designated medical services provided by designated medical institutions for the insured.

Reimbursement of basic medical service facilities

The reimbursement scope of basic medical insurance medical service facilities includes services provided by designated medical institutions, and the insured persons are receiving diagnosis, treatment and nursing.

The necessary living service facilities in the management process mainly include hospital bed fee or outpatient (emergency) observation bed fee.

What diseases can urban medical insurance reimburse?

Sexual tumor, leukemia, uremia, liver organ transplantation, kidney organ transplantation, aplastic anemia, pulmonary heart disease complicated with chronic heart failure, diabetic complications, rheumatoid arthritis, autoimmune diseases, hepatitis, cirrhosis, old myocardial infarction, chronic glomerulonephritis, cerebral thrombosis, cerebral hemorrhage, hypertensive heart disease, femoral head necrosis, malignant tumor, nephrotic syndrome, cardiovascular stent, cerebrovascular stent and vascular stent. Schizophrenia, Parkinson's disease, myelodysplastic syndrome, polycythemia vera, primary thrombocytosis, primary myelofibrosis, rheumatic valvular heart disease, myasthenia gravis, hemophilia and pituitary adenoma.

Diseases reimbursed by urban and rural medical insurance

Diseases are divided into four categories: malignant tumor, uremia, organ or tissue transplantation and hemophilia.

There are 8 kinds of second-class diseases, including leukemia, aplastic anemia, old myocardial infarction, myelodysplastic syndrome, active hepatitis, stent implantation, nephrotic syndrome and autoimmune diseases.

Systemic lupus erythematosus, hypertension, diabetes, rheumatoid arthritis, femoral head necrosis, severe psychosis, congenital adrenal hyperplasia, congenital hypothyroidism, liver cirrhosis, cerebral thrombosis and sequelae of cerebral hemorrhage, myasthenia gravis, cor pulmonale, phenylketonuria and cerebral palsy in children 14.

legal ground

People's Republic of China (PRC) Social Insurance Law (revised on 20 18)

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.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.