Office location: No.86 Jianshe North Road, Xi Du Town, Hengyang County (in Hengyang County Health Bureau)

Fax: 0734-68 1368 1

E-mail: hyxhgjzj @126.com.

Reimbursement process:

1, on-site reimbursement of medical expenses, designated medical institutions reduce fees according to regulations, and hospitals issue reimbursement invoices;

2. Waiting for the discharge notice;

3, medical records (build official seal of the hospital);

4. The hospital issued a summary list of expenses, hospital grade certificate, diagnosis certificate, medical insurance card and other materials required by the reimbursement department.

5. Wait for the hospital to announce the reduction and exemption on a monthly basis, accept the supervision of the masses, and submit an expense account after passing.

6. After the insured person is discharged from the hospital, the hospitalization invoice, discharge record, expense list, referral certificate, a copy of my ID card or the household registration certificate signed or sealed by the patient shall be handed over to the township joint management office, which will be sent to the municipal agricultural insurance business management center in a centralized and unified way after examination.

Reimbursement conditions:

1. Reimbursable expenses for outpatient and inpatient treatment of people participating in the new rural cooperative medical system in the county due to various diseases.

2, to participate in the county's new rural cooperative medical care personnel, during the work, business trip, business trip, visiting relatives, in the county outside the local medical insurance designated medical institutions for outpatient and inpatient treatment according to the provisions can be reimbursed.

3. The medical expenses for special diseases and the expenses for outpatient and inpatient treatment in local designated medical institutions outside the county shall be paid by myself first, and after the medical treatment, the relevant information shall be reported to the township where the household registration is located.

References:

Compensation for hospitalization of ordinary residents:

First, the general illness deductible line. 200 yuan, a general township health center in the county; 300 yuan, a county-level medical institution (including central hospital); Secondary medical institutions in 600 yuan (County Second People's Hospital, County Third People's Hospital 400 yuan); Hengyang Municipal Level III Medical Institution 1200 yuan; Local designated medical institutions outside Hengyang (excluding provincial designated medical institutions) 1500 yuan;

If you are hospitalized many times within one year, the cumulative deductible is limited to 2300 yuan.

Second, the proportion of general disease compensation: 90% of general township hospitals in the county; 85% of county-level medical institutions; 75% of secondary medical institutions (including 80% of County Second People's Hospital and Third People's Hospital); Hengyang city level 3 medical institutions 60%; ⑤ 55% of local designated medical institutions outside Hengyang (including provincial-level designated medical institutions in Hunan Province).

Third, the compensation standard for the daily bed fee limit of general township hospitals is 10 yuan; 20 yuan, a first-class medical institution; 23 yuan, a secondary medical institution; 25 yuan, a tertiary hospital.

Fourth, the maximum compensation limit for hospitalization. In a settlement year, the cumulative maximum compensation limit of urban and rural residents' medical insurance fund (excluding urban and rural residents' serious illness medical insurance) is 6.5438+0.5 million yuan.

Five, maternal delivery. According to the national birth policy, the hospital delivery expenses (including prenatal examination) shall be compensated according to the maximum amount. The maximum compensation per person for flat delivery is 1.300 yuan, and the maximum compensation per person for cesarean section is 1.600 yuan. The hospitalization expenses incurred by pregnant women due to high-risk treatment shall be paid according to the relevant hospitalization standards.

Six, the insured residents due to mental illness in Hengyang city within the scope of the designated psychiatric hospital hospitalization, according to the daily cost of beds contract policy implementation.

Seven, accidental injury. The specific rules shall be formulated separately according to the provincial and municipal documents.

8. critical illness insurance.

1. After deducting the critical illness insurance deductible line 14000 yuan, the insured residents will accumulate compliance medical expenses in a natural year;

Cumulative compensation in four stages: 60% of 0 to 30,000 yuan (inclusive) and 65% of more than 30,000 to 80,000 yuan (inclusive); 75% will be compensated for the part above 80,000 yuan to150,000 yuan (inclusive) and 85% for the part above150,000 yuan. In addition to the annual cumulative compensation limit for critical illness insurance, it is 300,000 yuan.

2. critical illness insurance's compliance fees include partial policy self-payment, segmented individual self-payment and deductible individual self-payment.

Out-of-pocket expenses outside the "three catalogues" of medical insurance, out-of-pocket expenses for outpatient service (including general outpatient service and special outpatient service), out-of-pocket expenses for outpatient service using special drugs, out-of-pocket expenses for hospital delivery (except for treatment of complications), medical expenses for accidental injuries, and other medical expenses not paid according to medical insurance policies are not included in the payment scope of major illness insurance.

3. The deadline for annual payment of serious illness insurance project is March 3 1 of the following year.

References:

Hengyang County People's Government-Compensation for Basic Medical Insurance for Urban and Rural Residents in 2020