2021 Chronic Disease Processing Time

I. Quarterly declaration acceptance time:

20th-30th of March, June, September and December (except holidays)

II. Place of declaration acceptance:

Medicare Business Window

III. Required documents for declaration:

(1) For hospitalization:

(2) Without hospitalization: 1) Diagnostic certificate; 2) Social security card or ID card; 3) Hospitalization records: 1) A copy of the hospitalization records; 2) A copy of the social security card or ID card; 4) A copy of the hospitalization records. 1, a copy of hospitalized medical records; 2, social security card or ID card

(b) not hospitalized need to provide:

1, diagnostic certificates; 2, a copy of two years of consecutive outpatient medical records; 3, a copy of the recent laboratory reports or inspection reports

four, the above materials required to the second level of public hospitals, the relevant materials within two years.

After receiving the application form, the participant is required to attend the medical examination and appraisal according to the time and place specified on the form, and those who fail to attend the appraisal on time are regarded as automatically giving up this application.

V. Reimbursement Standard for Common Chronic Diseases

There is no starting line for outpatient reimbursement of common chronic diseases, and the reimbursement rate is 60%. However, the total annual reimbursement is capped at 3,000 yuan. Patients can settle their claims at any time or on a regular cumulative basis. Common chronic diseases include hypertension (stage II and III), coronary heart disease (myocardial infarction), cerebral hemorrhage and recovery from cerebral infarction, chronic ulcerative colitis, decompensated cirrhosis of the liver, diabetes mellitus, rheumatism and other diseases.

VI. Reimbursement Standard for Special Chronic Diseases

The outpatient reimbursement for special chronic diseases does not set a starting line, and its reimbursable expenses are directly comparable to the inpatient reimbursement policy of hospitals of the same level, and can be reimbursed once every quarter. Special chronic diseases include leukemia, hemophilia, schizophrenia, malignant tumors, organ transplantation anti-discharge treatment, and post vascular stent implantation.

VII. It should be noted that the reimbursable expenses for common chronic diseases and special chronic diseases are the expenses for specialized medicines, examinations and treatments necessary for the disease. According to the relevant provisions of the Regulations on the Supervision of the Use of Medical Security Funds, the illegal and illicit acts of fraudulent use of medical insurance funds through forgery, alteration of medical documents or fictitious medical services, etc., shall be seriously investigated and dealt with in accordance with the law and the disqualification of treatment. It shall not be allowed to re-apply within two years, and shall be the key monitoring object and notify the insured units and communities, health centers, etc. in written form. If the loss of health insurance fund is caused, the health insurance fund will be recovered. The seriousness of the case transferred to the judicial organs to investigate criminal responsibility according to law.