How long can I apply for medical insurance reimbursement after discharge?

There is a time limit for medical reimbursement. Should be reimbursed within six months after diagnosis and treatment. Generally, it will be reimbursed in the second half of this year and in the first half of this year. If reimbursement is made in time at the time of discharge, the unpaid part can be paid at the time of discharge.

According to the basic requirements for the payment of basic medical insurance benefits, the insured person who goes to the medical insurance institution to reimburse the medical expenses incurred by his medical treatment generally meets the following conditions: (1) The insured person must go to the designated medical institution of basic medical insurance to buy medicine, or go to the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital. (2) The medical expenses incurred by the insured in the process of medical treatment must conform to the basic medical insurance drug list, diagnosis and treatment items, the standard scope of medical service facilities and payment standards, and be paid by the basic medical insurance fund according to regulations. (III) Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part that is higher than the Qifubiaozhun of the social medical co-ordination fund and lower than the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion.

Proportion of medical insurance reimbursement:

1, outpatient and emergency medical expenses: the medical expenses that meet the requirements of basic medical insurance in the year (11October1February 31February) exceeded 2,000 yuan.

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.

4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.

Documents and materials required for medical insurance reimbursement:

(1) Measures for reimbursement of local residents' medical insurance designated hospitals

1. Within three days after admission, the patient shall go through the medical insurance registration formalities at the medical insurance office of the designated hospital with the admission notice and medical insurance certificate. During hospitalization, the medical insurance certificate shall be kept by the medical insurance office of the hospital and returned to me at the time of discharge settlement.

If you don't register for more than three days, the hospitalization expenses will be borne by yourself.

2. When leaving the hospital, you should go to the hospital medical insurance office to go through the medical insurance discharge settlement procedures.

3. If the insured residents pay the medical insurance premium in full and on time, the medical expenses paid by the medical insurance pooling fund when the patients leave the hospital will be directly reimbursed by the hospital.

Legal basis: People's Republic of China (PRC) 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.