How to reimburse the social security ratio after hospitalization in Wuhan

Insurance Bian Xiao helps you answer, and more questions can be answered online.

The processing method of Wuhan medical insurance reimbursement is as follows: the reimbursement condition is 1, and the applicant has gone through the insurance formalities and paid the medical insurance fee in full.

2, cooperative medical designated medical institutions for medical treatment;

3. The medical expenses incurred by the insured in hospitalization in medical institutions shall be paid in cash in advance, and relevant documents and materials shall be kept.

Handling materials

Individuals will arrange medical expense documents and related materials in chronological order and submit them to the unit (or social security office) for reimbursement.

1, original receipt;

2, hospitalization expenses statement;

3, discharge diagnosis certificate;

4. Copy of observation certificate or death certificate;

5, drugs, examination and treatment costs, emergency observation need to be stamped with the "emergency chapter" of the medical insurance prescription or emergency prescription of the emergency department;

6, social security card, "urban medical insurance manual";

7, the hospital full checkout certificate and unit description.

Treatment process

1. The agent submits the reimbursement documents and other materials to the Dark Grey Insurance Fund Administration for acceptance;

2. After receiving the application materials, the accepting department will complete the examination, settlement and payment on the same day;

3, the social insurance fund management bureau to review the materials and approve the application, the applicant to receive the "social medical insurance medical expenses reimbursement form", be reimbursed.

Reimbursement ratio

1, the general outpatient medical expenses will be increased to 30% of the expenses in 300 yuan and below, and the reimbursement amount of residents' medical insurance outpatient expenses will be increased to 90 yuan per person per year.

2. For hospitalization expenses above Qifubiaozhun and below the annual maximum payment limit, the reimbursement ratio of residents' medical insurance fund: 60% in tertiary medical institutions, 70% in secondary medical institutions, and 80% in community health service centers, primary medical institutions and Huimin hospitals; The proportion of medical insurance reimbursement for employees in tertiary, secondary and primary medical institutions is 86%, 89% and 92% respectively.

3. The hospitalization expenses shared by the large medical insurance fund for urban workers and the insured according to the current large medical insurance policy are 654.38+10,000 yuan to 200,000 yuan, and the part exceeding 200,000 yuan will continue to implement the current large medical insurance policy for urban workers.

4, to participate in the urban basic medical insurance in Wuhan and enjoy the treatment of the disabled hospitalization, there is no Qifubiaozhun, while the urban basic medical insurance fund payment ratio increased by 2% on the basis of the current policy.

Handling place

Medical insurance is located in the hospital payment office.