How to reimburse hospitalization medical insurance in different places in Beijing

Legal analysis: 1. Conditions for filing medical treatment in different places: The following persons who participate in basic medical insurance can apply for direct settlement and filing of medical expenses for cross-provincial hospitalization.

(1) Resettlement of retirees in different places: refers to those who have settled in different places after retirement and whose household registration has moved to their place of residence.

(2) Long-term residents in different places: refers to those who live in different places and meet the requirements of the insured place.

(3) Resident in different places: refers to the personnel who are sent by the employer to work in different places and meet the conditions of the insured place.

(4) Referral personnel from different places: refers to those who meet the referral conditions of the insured place.

Two. Records of medical treatment in different places:

1, social security card;

2 Beijing basic medical insurance hospitalization medical expenses direct settlement registration form.

Three. Procedures for filing medical treatment in different places:

(a) login Ministry of Human Resources and Social Security "social insurance online query system"; Inquire about the "National Designated Medical Institutions in Different Places" that can be directly settled.

(2) Log in to "Beijing Social Insurance Online Service Platform"; Read the Informed Consent for Direct Settlement of Inter-provincial Inpatient Medical Expenses of Beijing Basic Medical Insurance; Download and fill in the Registration Form for Direct Settlement of Inter-provincial Inpatient Medical Expenses of Beijing Basic Medical Insurance (hereinafter referred to as the Registration Form for Direct Settlement) in duplicate.

(three) the employer of the insured person shall go through the formalities of "activation of hospitalization card" for the social security card with the social security card of the insured person (hereinafter referred to as social security card) to the medical insurance agency to which the insured person belongs. (Note: If the insured has gone through the hospitalization settlement formalities in this city with the social security card, there is no need to go through the "hospitalization card activation" formalities. )

(four) the employer holds the "direct settlement registration form" in duplicate and the social security card of the insured person to apply to the social security agency for the direct settlement of medical treatment in different places for the insured person.

(five) after the direct settlement of hospitalization expenses in different places is completed, it will take effect the next day.

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.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Thirty-first social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.

Medical institutions shall provide reasonable and necessary medical services for the insured.