1. The following information must be provided for reimbursement: 1. Special invoice and summary list of hospitalization expenses (stamped with the official seal of the hospital).
2. Disease diagnosis certificate or discharge summary (stamped with the official seal of the hospital).
3. Copy of personal ID card.
4. The social security card of the insured person must be activated and the financial account must be activated (if you do not have a social security card, please provide the original bank account and ID card of the insured person).
I or I may entrust others to bring relevant information to the Lianjiang Municipal Medical Insurance Bureau to apply for reimbursement as soon as possible this year.
2. Under what circumstances can I apply for manual reimbursement through my employer or social security office for fully advanced medical expenses?
1. The insured person sought medical treatment after the insurance card was not issued, the card was not held in the emergency room, the card was pressed during hospitalization and discharge settlement, the social security card was replaced, and the unit was in arrears, etc.
2. When designated pharmacies purchase drugs, they fail to settle in real time due to problems with the medical insurance system, etc., and meet the payment conditions of the medical insurance fund.
3. Medical expenses for prenatal examination and family planning outpatient surgery.
4. Medical expenses for medical treatment in other places that comply with Beijing’s medical insurance regulations.
In the above cases, the individual must advance the medical expenses in full, keep the receipts, prescriptions, diagnosis certificates and other materials issued by the hospital, and submit them to the unit (or social insurance office) to the district medical insurance agency to apply for manual reimbursement.
3. How do insured persons apply for manual reimbursement of fully advanced medical expenses?
1. Urban employee medical insurance participants will hand over the materials to their unit to be responsible for manual reimbursement procedures (if retirees have chosen the nearest social security office for reimbursement, individuals can go to the social security office to apply); 2. Urban and rural residents medical insurance participants will
The materials are handed over to the social security office in the place of insurance participation or residence to handle the manual reimbursement procedures.
4. How does the employee’s employer or social security office handle manual reimbursement for insured persons?
The social security enterprise version software used by the unit or social security office enters the medical expense bill information of the insured person, forms an electronic offer document, and prints the corresponding application form, which together with the relevant documents provided by the insured person is compiled to form a complete application material.
The staff will submit the electronic offer documents and paper application materials to the medical insurance agency in the insured area.
Legal basis: Article 23 of the Social Insurance Law: Employees shall participate in the basic medical insurance for employees, and the employer and employees shall jointly pay the basic medical insurance premiums in accordance with national regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.