The latest off-site medical insurance policy regulations

The latest policy on reimbursement of off-site medical insurance in 2017

I. Conditions for reimbursement of off-site medical insurance

1, the insured who have handled the registration procedures of off-site resettlement, visiting relatives, working and studying abroad and other out-of-town medical treatment, and the situation of advancing cash for medical expenses incurred in off-site medical insurance designated medical institutions.

2. Provincial-level insured persons agree to transfer to the designated medical institutions in Beijing and Shanghai for medical expenses incurred by cash advances for the record.

The reimbursement rate of outpatient medical insurance (up to 90%)

1, outpatient reimbursement rate

General outpatient clinic does not set a starting line of general outpatient treatment of all insured residents are entitled to general outpatient treatment. Within a medical insurance year, there is no starting line for general outpatient treatment, and medical expenses within the scope of the outpatient coordinating fund are reimbursed at a rate of 60%, with an annual individual maximum payment limit of 400 yuan for the coordinating fund.

2. Hospitalization reimbursement rate

. The longer the period of continuous participation, the greater the reimbursement rate of the insured residents continuous contributions for every 5 years, the hospitalization reimbursement rate of the medical insurance fund increased by 5 percentage points, the cumulative total of no more than 10 percentage points. If you have been insured for 10 consecutive years since 2007, the reimbursement rate for hospitalization in a tertiary, secondary and primary hospital will be 70%, 80% and 90% respectively.

3, the second reimbursement rate

"Second reimbursement" may also have "reimbursement" in the insured residents of a single hospitalization incurred in the medical expenses, is the urban residents of the basic medical insurance co-ordination fund within the scope of the payment of the part of the basic medical insurance co-ordination fund. The part of the medical expenses incurred in a single hospitalization that is covered by the urban residents' basic medical insurance comprehensive fund, after being paid by the basic medical insurance comprehensive fund according to the proportion, and the part of the individual's burden that exceeds 8,000 yuan or more, will be reimbursed by the funds of the major disease insurance at a rate of 55% of the excess.

Three, the process of reimbursement of foreign medical insurance

1, receive or download on the social security website, "the city's basic medical insurance to work, live in a different place, the situation of the declaration form" (hereinafter referred to as "declaration form");

2, according to the provisions of the fill in, and by the field of social insurance (medical insurance) by the agency stamped with the recognition of the "declaration form";

3, will be filled out after the The "declaration form" back to the division of responsibility of the social insurance agency to review and confirm. Shall apply for the province's medical card, after the audit confirmed by the "declaration form" to the municipal social security center audit section for registration, and then to the social security card management section for the province's network of cards for the card procedures;

4, for the preparation of the individual social security card can not be used in the use of the insured; insured persons to return to have to be in the medical treatment should be canceled in the municipal social security institutions to the medical preparation from the next day onwards, the individual social security card can be used in the designated medical care;

3, will be filled out and returned to the division of responsibility for social security agencies to review and confirm. Social security card can be used in the designated medical institutions;

5, the implementation of medical reporting changes in the report, no change in the principle of non-reporting.

Four, different medical insurance reimbursement required materials

1, a copy of the application form for medical treatment in a different place

2, the regular invoice of the drugstore (supervised by the Ministry of Finance of the State Administration of Taxation and listed on the invoice of the details of the purchased drugs) or outpatient receipts of designated hospitals

3, the patient's own identity card and the identity card of the person who acted on behalf of the patient

4, the account number of my passbook card (except for rural credit unions) (except for rural credit unions) (the patient's personal social security card), the patient's personal social security card and his/her own social security card. Credit Union (except) (foreign accounts need the name of the depositary bank)

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