Xinjiang 202 1 urban and rural medical insurance reimbursement policy

Xinjiang 202 1 urban and rural medical insurance reimbursement policy;

1, the first-level medical institutions were adjusted from 60% to 75%;

2, secondary medical institutions from 50% to 60%;

3, tertiary medical institutions from 40% to 45%.

Reimbursement scope:

1. Reimbursable expenses for temporary medical treatment in different places and hospitalization in different places are limited to medical expenses incurred in local rescue due to acute and critical diseases;

2 because the local medical conditions can not be cured and need to go to other places for medical treatment, it shall go through the referral procedures outside the region. Only tertiary medical institutions with referral qualifications in Urumqi can issue referral certificates before reimbursement;

3. Long-term off-site filing time is at least one year, during which the social security card is suspended in Urumqi, and the balance of the personal account of medical insurance is returned to the social security payment bank card of the insured at the beginning of the following year, and the off-site filing shall not be terminated within one year of filing;

4. If there is no payment information of the medical insurance bank, it is necessary to provide the deposit and withdrawal business receipt of the insured person at the bank counter of Urumqi Social Security Agreement.

Reimbursement process:

1. Within 6 months after the end of medical treatment, the insured shall apply for reimbursement of medical expenses with hospitalization materials and grade materials of medical institutions to the medical insurance treatment payment office of Urumqi Social Insurance Administration;

2, the insured and the applicant should promise to submit materials to prove effective, have known that the use of false materials to defraud the medical insurance fund, will terminate the enjoyment of medical insurance benefits and handed over to the judicial department for legal responsibility. And issue a power of attorney authorizing Urumqi Social Security Bureau or its entrusted institution to inquire about medical expenses;

3, the audited data and related medical expenses in line with the basic medical insurance fund to pay the scope of medical expenses in accordance with the relevant provisions of reimbursement, reimbursement amount in accordance with the insured person to declare the way to receive payment from me. If you exceed the time limit for filing, you will not be able to enjoy medical insurance benefits without special reasons.

legal ground

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

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.