1. Social medical insurance reimbursement is reimbursed after discharge or transfer to another hospital. You can use your medical insurance card to register and see a doctor directly. If you have a balance in your card, you can also pay for the medicine directly after the doctor prescribes it.
Policies and standards vary from place to place. Generally speaking, if you do not show your medical insurance card when seeking medical treatment (except for rescue), the medical expenses incurred will not be reimbursed. Consult directly with the local medical insurance handling department, or call the local social security consultation service hotline 12333 for consultation.
2. Settlement procedures for hospitalization and outpatient treatment of special diseases:
1. Before the 10th of each month, designated medical institutions will submit the cost settlement sheets and hospitalization settlement of patients discharged last month. The bill and relevant information shall be submitted to the medical insurance agency. After review by the medical insurance agency, it will be used as the basis for monthly pre-allocation and year-end final accounts;
2. The medical insurance agency shall pre-allocate the previous month every month The overall cost of hospitalization and outpatient treatment of special diseases;
3. Insured persons who are identified as suffering from special diseases should go to a designated medical institution designated by the labor and social security department for medical treatment and purchase of medicines, and the medical expenses incurred Direct billing, instant settlement.
Extended information:
1. Outpatient clinic
Village clinics and village central clinics are reimbursed 60 yuan, with a limit of 10 yuan for prescription drugs per visit. Health centers The doctor's temporary rehydration prescription drug fee limit is 50 yuan;
The town health center reimburses 40 yuan, the examination fee and surgical fee limit for each visit is 50 yuan, and the prescription drug fee limit is 100 yuan;
A visit to a second-level hospital is reimbursed NT$ 30, with a limit of NT$ 50 for various examination fees and surgical fees, and a limit of NT$ 200 for prescription drugs;
A NT$ 20 is reimbursed for a visit to a tertiary hospital, and NT$ 2 is reimbursed for a visit to a tertiary hospital, with a limit of NT$ 50 for various examination fees and surgical fees for each visit. The fee limit is 50 yuan, and the prescription drug fee limit is 200 yuan;
The traditional Chinese medicine invoice attached to the prescription has a limit of 1 yuan per prescription; the annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.
2. Hospitalization
Reimbursement scope:
Drug expenses: auxiliary examinations: ECG, X-ray, radiographs, laboratory tests, physical therapy, acupuncture, The limit for CT, MRI and other examination fees is 200 yuan;
Surgery fees (refer to national standards, if the cost exceeds 1,000 yuan, it will be reimbursed at 1,000 yuan). If an elderly person over 60 years old is hospitalized in a health center, the treatment and nursing fees will be compensated 10 yuan per day, with a limit of 200 yuan.
Baidu Encyclopedia - Medical insurance reimbursement ratio