Foshan hospitalization social security reimbursement process

Foshan medical insurance hospitalization can be reimbursed in Hubei.

Reimbursement conditions

Qifubiaozhun for hospitalization: tertiary hospital 1. 200 yuan/time, retirement 1. 000 yuan/time; Working in a secondary hospital in 600 yuan/time, and retiring in 500 yuan/time; First-class hospitals (including community designated medical and health service institutions, the same below) are in 400 yuan/time and retired in 300 yuan/time.

Insured persons who have been hospitalized for a long time (90 days): settle accounts with designated medical institutions once every 90 days, and calculate Qifubiaozhun for each settlement.

The hospitalization of the insured has reached the discharge standard: the hospital issued a certificate to go through the discharge formalities.

Insured: eligible Foshan basic medical insurance insured.

Reimbursement materials

1. On-site settlement: ID card/social security card of the insured.

2. Sporadic reimbursement: the expenses shall be paid in advance by the individual, and the following relevant materials shall be presented to the social security institution where the insured person is located for reimbursement of hospitalization medical expenses within three months after discharge (limited to 65438+ 0 visits per day).

(1) Original and photocopy of the insured's ID card (those who have not obtained the second-generation ID card can present other valid documents, such as household registration book).

(2) The original and photocopy of the agent's ID card.

(3) The following materials issued by the medical institution: the original receipt or invoice of medical expenses stamped with the special financial seal of the medical institution, the original detailed list of medical expenses with the same amount and date as the receipt (invoice), the original disease diagnosis certificate stamped with the seal of the medical institution, the original discharge summary stamped with the seal of the medical institution, and the original and photocopy of outpatient medical records (emergency only).

(4) The social security card of the insured. If the insured fails to receive or activate the social security card, it shall provide the original and photocopy of the bankbook or debit card with the name and account number on the card surface, or the certificate of comparison between the card number and account number issued by the issuing bank.

(5) To transfer to a medical institution outside the city, provide the Registration Form for the Transfer of the Insured Persons of Foshan Basic Medical Insurance or the Application Form for the Insured Persons of Foshan Medical Insurance to Seek Medical Treatment in a Medical Institution outside the city.

(6) Other certificates required by social security institutions.

(7) Qualified disabled persons can hold the People's Republic of China (PRC) Disabled Persons' Card.

Reimbursement process

1. The residents' medical insurance fund will not pay the outpatient treatment expenses for specific diseases that occur in designated medical institutions outside the city; However, the residents' medical insurance fund will not pay for those who are hospitalized due to illness with the approval of social security institutions.

2. If the insured person needs to be transferred to a higher-level medical institution in this Municipality for treatment due to illness, the treatment medical institution shall issue a transfer certificate and handle the transfer formalities for the first time in the year, and the transfer to a medical institution shall not be included in the payment standard; Two or more transfers, according to the calculation of Qifubiaozhun hospitalization again. If you are treated in a high-level medical institution and your condition is stable, and you leave the acute, critical or severe period and are transferred from a tertiary or secondary hospital to a primary hospital for further treatment, the payment standard will not be counted at the time of transfer.

3. Under normal circumstances, when you need to be hospitalized due to illness, you can go to your designated hospital with the medical insurance card and medical records, and settle with the medical insurance card. That is to say, some of them are paid by themselves at their own expense, and some medical insurance centers and hospitals reimburse and settle accounts.

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