Xi 'an Economic Development Zone Medical Insurance for Urban Residents

Xi economic and technological development zone basic medical insurance insured medical treatment process

1, the insured employees of the unit will enjoy the basic medical insurance for employees from the next month. Personal insurance enjoys basic medical insurance for employees from the sixth month after insurance.

2. When the insured person needs outpatient medical treatment, he shall go to the designated hospital for medical treatment with "special medical record", and settle the expenses with personal account (personal account card of Bank of Communications), or purchase medicines at designated pharmacies, and settle the expenses with personal account (bank card of Communications), and the excess shall be paid by personal cash. Except for special examination, special treatment and special diseases, the expenses in basic medical insurance coverage shall be paid by personal account, and the insufficient part of personal account shall be paid by personal cash.

3. Personal account (bank card) recording method: according to the monthly payment base of the insured, according to different age groups: under 40 years old, 2.7%; 4 1 to 50, 3.0%; 5 1 year and above, including 3.6%. 5% of the monthly pension for retirees is included.

4. When the insured workers need to be hospitalized, they should go to the designated hospitals for medical treatment with "special medical records", which is in line with the catalogue of hospitalized diseases. If they need to be hospitalized after outpatient diagnosis, an outpatient doctor will issue a "hospitalization certificate" and go through the hospitalization procedures after being audited by the Medical Insurance Office. The hospitalization expenses will be paid in full by themselves. Go to the treatment department to register a bed for treatment.

5. During hospitalization, after confirmation, sign the detailed card of hospitalization expenses every day, and sign the doctor-patient agreement on the use of non-drug list drugs, ultra-basic diagnosis and treatment projects and service facilities.

6. If the insured person needs to be transferred to a foreign hospital for treatment due to illness during medical treatment in a designated hospital, it shall be put forward by a hospital above Grade III, and can only be transferred to a foreign hospital for treatment after going through the examination and approval procedures in the social security center. Referral time generally does not exceed 30 days.

7. When leaving the hospital, you should go through the check-out formalities in the inpatient department. Within 30 days after discharge, the handling personnel shall bring the original and photocopy of the insured's ID card, special medical records, medical bills, expense list, medical diagnosis certificate, copy of the first page of hospital medical records, discharge records, hospital medical records, long-term doctor's advice and temporary doctor's advice to the social security center for reimbursement. (When entrusting others for special reasons, the handling personnel shall issue a power of attorney stamped with the official seal of the unit, and the handling personnel shall carry the power of attorney and my ID card. )

8, the basic medical insurance reimbursement amount, outpatient expenses are limited to personal account balance; When reimbursing hospitalization expenses, it should be deducted: the minimum payment, the self-paid part above the minimum payment and the expenses that are not within the scope of reimbursement. The annual reimbursement limit is 50,000 yuan, and the maximum Medicaid limit is 200,000 yuan.

9, medical insurance fund Qifubiaozhun:

First hospitalization, second hospitalization, third hospitalization and above.

Three-level dedicated 1000 850 600

Tertiary hospital 850 600 400

Secondary hospital

Level 1 hospital 500 300 250

(Note: Grade III specific hospitals include six hospitals including Xijing Hospital, Tang Dou Hospital, First Hospital of Jiaotong University, Second Hospital of Jiaotong University, Provincial People's Hospital and Central Hospital).

10, the individual pays more than the minimum payment ratio (%):

The conceit ratio of tertiary hospitals, secondary hospitals and primary hospitals at different ages and levels.

Under 35, under 36, after retirement, under 35, under 36, after retirement, under 35, under 36, after retirement, after retirement.

The minimum payment is more than 5,000 yuan161514131216 5438+00.

5000 rpm 10000 yuan14131211-

10000 yuan to the highest payment standard121165438-

1 1. List of designated hospitals: Xijing Hospital, Provincial Hospital, First and Second Hospitals of Xi Jiaotong University, Central Hospital of Xi, Chang 'an International Hospital, First, Fourth and Eighth Hospitals of Xi, 45/kloc-0 Hospital of the People's Liberation Army, 323rd Hospital of the People's Liberation Army, Affiliated Hospital of Xi 'an Medical College, Fengcheng Hospital and weiyang district No.1 Hospital.

12. Hospitals and pharmacies that can use credit cards: All provincial-level medical insurance pharmacies and provincial-level hospitals (except Xijing Hospital) in the city can use credit cards!