Where is the medical insurance reimbursement in Xiangyin County?

Take the social security card to the hospital or community clinic.

Article 28 of the Social Insurance Law stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

According to the basic requirements of the payment of basic medical insurance benefits in China, the insured person who goes to the medical insurance institution to reimburse the medical expenses incurred by himself for medical treatment generally meets the following conditions:

(1) The insured must go to the designated medical institution of basic medical insurance or to the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital.

(2) The medical expenses incurred by the insured in the process of medical treatment must conform to the basic medical insurance drug list, diagnosis and treatment items, the standard scope of medical service facilities and payment standards, and be paid by the basic medical insurance fund according to regulations.

(III) Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part that is higher than the Qifubiaozhun of the social medical co-ordination fund and lower than the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion.

Reimbursement ratio:

1, outpatient and emergency medical expenses

The accumulated medical expenses of employees who meet the basic requirements of medical insurance coverage during the year (65438+ 10/~ 65438+February 3 1) exceed 2000 yuan.

2. Settlement ratio

During the contract period, 50% of the dispatched personnel will be reimbursed for more than 2,000 yuan, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.

4. Outpatient treatment of three special diseases

When the insured suffers from malignant tumor radiotherapy and chemotherapy, renal dialysis, kidney transplantation and other diseases and needs to take anti-rejection drugs in the outpatient department, the second-and third-level designated hospitals where the insured is located will issue the Certificate of Disease Diagnosis, fill in the Declaration and Approval Form for Special Diseases of Medical Insurance, and report it to the District Medical Insurance Center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies.

5. Hospitalization.

After paying medical insurance for 20 years, you can enjoy medical insurance reimbursement after retirement. The scope of medical insurance reimbursement varies from place to place. Please refer to local policies for details.

Extended data

The use of social medical insurance card is as follows:

1, scope of use of medical insurance card

Insured employees can swipe their cards on POS machines with passwords when purchasing medicines in designated hospitals and pharmacies, but they cannot withdraw cash or transfer money.

2, medical insurance card balance query

Insured employees can inquire about the balance by telephone, or at China Bank Savings Office or designated hospitals and pharmacies in urban areas. You can also log in to the social security inquiry system online.

3, medical insurance card transaction query

Insured employees can print medical insurance card transaction records with their ID cards and medical insurance to China Bank Savings Office, including expenditure records and consumption records of personal account funds. If you have any questions about the transaction records, you can go to the retail business department of Bank of China.

4, medical insurance card password

If the insured employees change their passwords, they can make changes by phone, or they can make changes with their ID cards at China Bank Savings Office. If the insured employee forgets his password, he can report the loss of the original password with his ID card to China Bank Savings Office and change it.

5, medical insurance card custody

Insured employees should take good care of their medical insurance cards. If you accidentally lose it, please immediately issue a letter of proof to the unit and stamp it in the medical insurance office for confirmation. Then, they will take their ID cards to China Bank Savings Office to report the loss and go through the replacement procedures. After 7 days, they can get a new card.

6. Matters needing attention

When the number of medical insurance card transactions reaches 60, the insured employees must print the transaction records at China Bank Savings Office, or stop using the card. After the transaction record is printed, the card can continue to be used.

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