How to go to the medical insurance reimbursement process?

First, patients hospitalized in designated medical institutions in the region.

Show your medical insurance card first, and then pay a certain threshold fee according to the level of the hospital. After discharge, you can enjoy medical insurance benefits at the hospital medical insurance settlement office.

B, reimbursement procedures for inpatients in different places

(1) Declaring settlement information

Please bring the following information for reimbursement of hospitalization in different places.

1, hospital invoice (seal)

2. Detailed list of hospitalization expenses (seal)

3. Discharge record (seal)

4, the use of drugs outside the directory and special diagnosis and treatment project copy (seal)

5. Medical insurance card

6, complete procedures of "Wuhan caidian district urban workers medical insurance referral form".

(2) Settlement

The hospitalization procedures in different places are complete, and the reimbursement will be settled with the receipt and my ID card (the consignee needs to provide the consignee ID card) after 5 working days. Reimbursement will be suspended from 28th to the end of each month, and resumed the following month 1 day.

Second, the outpatient reimbursement procedures for seriously ill patients

(1) reimbursement time

Reimbursement time of hypertension and diabetes in critical outpatient department: 1 quarter March; The second quarter is June; The third quarter is September; The fourth quarter is 65438+February.

The outpatient department of other diseases is reimbursed once a month.

(2) Reporting settlement data

1, outpatient medical receipt; 2, Chinese prescription unit price and seal; 3. Check the original attached inspection report.

(3) Settlement

After 5 working days, the settlement reimbursement amount will be directly transferred to our bank.

Legal basis:

Article 27 of the Social Insurance Law of People's Republic of China (PRC) * * * If an individual who participates in the basic medical insurance for employees reaches the statutory retirement age and the accumulated payment reaches the fixed number of years stipulated by the state, he will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state.

Derivative problem:

Non-designated hospital hospitalization application and reimbursement procedures?

If the insured person needs to be hospitalized in a non-designated hospital due to illness, he/she should hold the transfer certificate and hospitalization application from a designated hospital at or above the second level → the medical insurance bureau approves → he/she should be hospitalized in the approved hospital → he/she should hold the original and photocopy of the medical insurance (social security card) or ID card, and ask the competent doctor and nurse to sign the medical insurance (social security card) or ID card copy to confirm that his/her hospitalization is true and confirmed by the medical insurance office → he/she should call the medical insurance bureau of the insured place within 3 days.