Beijing Abortion Social Security Reimbursement Process

Workers who participate in maternity insurance should show their social security card (or the certificate of getting a new social security card and replacing it) and Beijing Maternity Service Certificate (or Beijing Migrant Workers' Maternity Service Contact Sheet (for maternity insurance)) when seeking medical treatment.

Maternity-related medical expenses incurred in outpatient service shall be paid by individuals in cash first, without using "social security card" for credit card settlement, and the details, prescriptions, original receipts and related vouchers of maternity insurance medical expenses shall be properly kept. The medical expenses paid by the maternity insurance fund according to the regulations shall be summarized by the employer, filled in the corresponding form, and reported to the payment area, county and county medical insurance center participating in maternity insurance for settlement on June 1-20.

The related expenses incurred in hospitalization are accounted by the hospital according to the relevant provisions of maternity insurance, and there is no need for manual reimbursement by the medical insurance center. You can apply for manual reimbursement only because you were blacklisted at the time of admission or did not bring a "social security card" or a "new or replacement" social security card certificate at the time of emergency admission.

First, Beijing maternity insurance reimbursement instructions

(1) Medical expenses for childbirth

1, medical expenses for prenatal examination

2. Medical expenses for childbirth

(2) Family planning medical expenses

Medical expenses incurred by workers in placing (taking out) intrauterine devices, induced abortion, induced labor, sterilization and recanalization due to family planning needs.

Two, the declaration of maternity insurance medical expenses need to submit materials.

(a) the materials to be submitted to declare the medical expenses for prenatal examination.

1, Summary of Declaration and Settlement of Manual Reimbursement of Medical Expenses for Maternity Reimbursement in Beijing (hand-filled, one copy, stamped; District medical insurance center to receive or download online)

2, "Beijing maternity insurance medical expenses manual reimbursement declaration form" (hand-filled, in duplicate, with official seal; District medical insurance center to receive or download online)

3. Original bill

4, Beijing medical insurance special prescription bottom side

5, check, treatment list

6. Copy of medical diagnosis certificate (weeks of pregnancy required)

7. Copy of Beijing Maternity Service Certificate or Beijing Migrant Workers' Maternity Service Contact Sheet (for maternity insurance).

8, the baby's birth certificate (or death, cited (flow) certificate) copy.

9. Copy of marriage certificate

(two) materials to be submitted when reporting maternity medical expenses.

1, Summary of Reporting and Settlement of Manual Reimbursement Expenses of Maternity Insurance in Beijing (hand-filled, one copy, stamped; District medical insurance center to receive or download online)

2, "Beijing maternity insurance medical expenses manual reimbursement declaration form" (hand-filled, in duplicate, with official seal; District medical insurance center to receive or download online)

3. Original receipt

4. Detailed list of medical expenses

5, the hospital full checkout certificate

6, unit description

7. Copy of medical diagnosis certificate (pregnant age required)

8. Copy of Beijing Maternity Service Certificate or Beijing Migrant Workers' Maternity Service Contact Sheet (for maternity insurance).

9, the baby's birth certificate (or death, cited (flow) certificate) copy.

10, copy of marriage certificate

(three) the materials to be submitted when reporting the medical expenses for family planning.

1, Beijing maternity insurance manual reimbursement of medical expenses manual reimbursement expense declaration and settlement summary table (hand-filled, one copy, stamped; District medical insurance center to receive or download online)

2, "Beijing maternity insurance medical expenses manual reimbursement declaration form" (hand-filled, in duplicate, with official seal; District medical insurance center to receive or download online)

3. Original receipt

4. Detailed list of medical expenses

5, check, treatment list

6, medical diagnosis certificate (copy)

7, issued by the unit in line with the family planning policy certificate (official seal or personnel and labor seal)

Third, matters needing attention

1, employees enjoy maternity insurance benefits, which should comply with relevant state regulations and family planning skills, while unmarried employees do not enjoy maternity reimbursement benefits;

2. The prenatal examination fee shall be declared once after the birth of the child, and the deadline for declaration is 65438+ the following year1October 20th;

3, the employer shall timely collect the relevant materials of the insured maternity reimbursement expenses, and according to the time sequence of the expenses, according to the order of the materials submitted after binding to Haidian District Medical Insurance Center;

4. The holder of the foreign birth service certificate needs to go to the street family planning department where the household registration in this city is located to exchange for the "Contact Sheet of Birth Service for Migrant Workers in Beijing (for maternity insurance)";

5 missed abortion, incomplete abortion, complete abortion, curettage, threatened abortion (pregnancy protection, pregnancy status, etc.). Does not belong to the basic medical care, and social security is the first consultation according to the prescription) does not belong to the category of maternity insurance, and the current expenses are applicable according to the basic medical expenses; Previously, the relevant outpatient examination fees were declared according to the prenatal examination of maternity insurance;

6. Because nobody in Beijing is in charge, the hospitalization expenses of giving birth in other places are reimbursed by the unit, with detailed information.

7. When declaring delivery expenses in other places, you need to provide a hospital-level certificate issued by the local medical insurance department;

8, birth reimbursement form is complete, not empty, the amount is accurate.

9. When you return the form and declare it again, please fill in the Summary of Declaration and Settlement of Manual Reimbursement of Medical Expenses for Maternity Insurance in Beijing in addition to the declaration form;

10, Declaration Form and Project Category

Total cost of western medicine: western medicine

Total cost of traditional Chinese medicine: Chinese patent medicines and Chinese herbal pieces.

Total examination expenses: routine examination, CT, MRI, B-ultrasound and radiology.

Total treatment expenses: treatment expenses, operation expenses, blood transfusion expenses, oxygen delivery expenses, delivery expenses and anesthesia expenses.

Total laboratory expenses: laboratory expenses.

Total material cost: material cost.

Other total amount: other, bed fee, heating fee, bed accompanying fee, nursing fee and medical fee.

I hope I can help you.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.