Shenzhen social security second file reimbursement scope

The scope of application of Shenzhen secondary social security card includes medical treatment and referral. The secondary insured of basic medical insurance shall go to the selected community health center for medical treatment. With the consent of the settlement hospital, you can go to other designated community health centers under the same settlement hospital for medical treatment. Inpatient and outpatient diseases are treated in designated medical institutions in Shenzhen.

Proportion of reimbursement for second-class social security hospitalization in Shenzhen:

1, the second kind of medical insurance is inpatient medical insurance.

2, outpatient service can be reimbursed every year 1000 yuan.

3. If you are hospitalized, you can basically reimburse 70% to 80%. Before going through the hospitalization formalities, you can show your social security and fill it out. When you leave the hospital, you will directly deduct the expenses that can be reimbursed.

Enjoy medical insurance benefits:

(a) the basic medical insurance insured in the city designated medical institutions for medical treatment.

(2) The secondary insured of basic medical insurance shall seek medical treatment in the selected community health center, and with the consent of the settlement hospital, they may seek medical treatment in other designated community health centers under the same settlement hospital as the selected community health center; Hospitalization and outpatient serious illness in the city designated medical institutions for medical treatment.

(3) The third-level insured of basic medical insurance shall seek medical treatment in the selected community health center, and with the consent of the settlement hospital, they may seek medical treatment in other designated community health centers under the same settlement hospital as the selected community health center; Outpatient serious illness in the city designated medical institutions for medical treatment; Be hospitalized in the settlement hospital of the selected social rehabilitation center.

(4) Other medical conditions that meet the requirements.

legal ground

Social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope: (1) should be paid by the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be borne by public health; (4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Thirty-second individuals across the overall regional employment, the basic medical insurance relationship with my transfer, the cumulative payment period.