How to reimburse large medical expenses?

1, need to see a doctor in the designated medical institution of cooperative medical system;

2. Original invoice;

3. Medical insurance card and my ID card. The large medical expenses paid by the insured in the designated hospitals shall be reimbursed by the designated hospitals to the large medical insurance office after the insured pays the self-payment ratio to the designated hospitals in accordance with the regulations; The insured person goes to the referral hospital for medical treatment. Because the large medical expenses are paid in advance by the individual, such personnel should submit medical records, invoices and lists to the large medical insurance office for reimbursement; For insured persons who have incurred large medical expenses in designated hospitals, they can submit medical records, invoices and lists to the big medical insurance office for reimbursement after discharge. Applicants should follow the relevant reimbursement procedures when reimbursing medical expenses to ensure the smooth realization of reimbursement.

Materials required for reimbursement of large medical insurance

1, table type:

(1) Handover Form of Medical Expense Declaration Documents of Basic Medical Insurance (No.17 of Tianjin Social Security Medical Center);

(2) Application and Payment Form for Large Medical Expenses for Outpatient (Emergency) Diagnosis (No.8 Form of Tianjin Social Security Medical Center);

(3) Examination Form for Payment of Large Medical Expense Subsidies for Outpatient (Emergency) Clinic (No.9 Form of Tianjin Social Security Medical Department);

(4) Personal declaration and payment form for medical expenses of urban workers.

2, outpatient full reimbursement required materials:

(1) social security report receipt verification (designated hospitals connected to the network need to be stamped with full advance stamp or network failure stamp);

② List of outpatient expenses;

③ Below the prescription corresponding to the drug fee receipt;

(4) Copy of social security card or ID card.

3, emergency fully observe the required materials in advance:

(1) Verification of social security report of medical insurance bill (full advance stamp is required);

② Detailed list of outpatient expenses;

(3) the prescription of the medical insurance bill;

(4) emergency observation certificate (indicating the disease to be observed, the starting and ending dates, whether the patient is hospitalized after observation, and the observation time should be continuous, and stamped with the special seal for medical insurance and the emergency chapter);

⑤ Copy of social security card or ID card. The hospitalization expenses shall be declared after settlement.

Large medical insurance reimbursement process

1. In case of network failure, loss of social security card, degaussing, card suspension, etc., the insured shall pay the outpatient medical expenses in full.

2, the insured unit is responsible for the collection, paste, fill in the report and summary (fill in the medical No.9, No.8 handover form), stamped with the official seal of the unit, and declare to the social security sub-center where the insured person is located. Municipal civil servants medical expenses reported to the medical insurance settlement center; The medical expenses of AIDS patients are reported to the infectious disease hospital.

Legal basis:

Article 25 of People's Republic of China (PRC) Social Insurance Law

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government. Article 26 of People's Republic of China (PRC) Social Insurance Law

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.