1, hospitalization invoice
2. Discharge certificate (all above shall be original)
3, hospitalization expenses and medication list (build official seal of the hospital, large-scale inspection should have a report, but large-scale inspection is generally at their own expense)
4. A copy of the household registration book or ID card.
5, the new rural medical insurance certificate
6. It is best to provide the social security certificate of the inpatient hospital, because there is a difference in the reimbursement ratio between designated and non-designated hospitals. The proof provided by the social security or new rural cooperative medical center where the inpatient hospital is located will be more convincing.
Bring the above information back to the new rural cooperative medical management team where the account is located for reimbursement.
At present, the proportion of reimbursement for medical treatment in hospitals outside the county where the household registration is located is very low. As low as 20% in Sichuan (non-fixed point 10%), the threshold fee of 1000 yuan and all self-funded items must be deducted first.
You don't need to write an application or issue a certificate. (unless the new farmer's guarantee does not match the name on the household registration book)
Rural medical insurance reimbursement for medical treatment in different places is not supported. It is best to see a doctor at the place of purchase, which is not supported. Therefore, it is necessary to obtain the approval of the local medical management institution before seeking medical treatment. The reimbursement of cooperative medical insurance is carried out in proportion, generally fluctuating around 20-85%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. In addition, it is also important to go to designated medical institutions for medical treatment.
Hello, the reimbursement rate of medical insurance in rural areas in Anlu.
If you are hospitalized in other provinces within 24 hours, be sure to contact the places where you participate in cooperative medical care and let them know that you are hospitalized in other provinces. You can ask the hospital to give you a certificate when you leave the hospital, and you can reimburse it locally when you come back. However, reimbursement for hospitalization in other provinces is no more than reimbursement for hospitalization insurance in the local area.
Article 54 If the insured's hospitalization expenses incurred in emergency treatment in other cities in China are approved to be referred to other cities in China, they shall be audited and reimbursed according to the relevant information such as hospitalization records, discharge diagnosis certificate or discharge summary, detailed list of expenses, original charge receipt and so on.
The basic medical expenses and local supplementary medical expenses of the insured who have been stationed in other cities in China for a long time or live in different places after retirement shall be reviewed and reimbursed according to the relevant medical records, discharge diagnosis certificate or discharge summary, detailed list of expenses and original receipt of expenses.
I hope I can help you, thank you
Can rural medical insurance in Guizhou be reimbursed in different places? 1, you must go through medical treatment or referral procedures in different places. If it is necessary to be transferred to a designated medical institution outside the city for treatment due to illness, the "Referral Record Form" filled out by the attending physician of the first-visit designated medical institution and stamped by the medical department can be transferred to the hospital after filing. Acute, dangerous and severe patients can be transferred to hospital first, and the transfer formalities can be completed within the prescribed working days. Without the approval of the referral, medical expenses will not be reimbursed.
2. The medical expenses for medical treatment in different places shall be paid by the individual first, and then reimbursed locally according to the regulations with the referral approval form, outpatient medical records, discharge summary, employee medical insurance medical record certificate, detailed list of expenses, and medical expense settlement documents.
It is suggested to consult the cooperative medical management center of the insured area first to avoid unnecessary losses.
Whether rural medical insurance can reimburse medical expenses for medical treatment in different places depends on whether the city where you live and the city where you see a doctor have signed such an agreement. If so, you can reimburse yourself. If not, you have to go through the relevant procedures to reimburse yourself. Just ask the nurse. When you are in hospital, the nurse will ask about reimbursement.
Can I go back to rural medical insurance for reimbursement for medical treatment in different places? The deductible line for how many patients of the new rural cooperative medical system are hospitalized in township hospitals is 100 yuan/person, and the reimbursement ratio is100% of the compliance expenses;
600 yuan/person-time, the reimbursement rate is 80%;
The deductible line for hospitalization in designated secondary hospitals in the city is 1000 yuan/person, and the reimbursement rate is 70%;
The deductible line for hospitalization in municipal tertiary hospitals is 1800 yuan/person, and the reimbursement rate is 60%;
The deductible for hospitalization in provincial tertiary hospitals is 3,000 yuan/person, and the reimbursement ratio is 55%;
The deductible line for hospitalization in provincial designated hospitals is 2000 yuan/person, and the reimbursement rate is 65%;
The reimbursement rate of designated private hospitals in the city is 5 percentage points lower than that of municipal secondary designated hospitals, and the reimbursement rate of non-designated hospitals in the city is 10 percentage point lower than that of municipal designated hospitals, with the deductible unchanged.
The hospitalization reimbursement process of the new rural cooperative medical system;
1, diagnosed by outpatient doctor or resident doctor, and issued hospitalization certificate;
2. Pay in the hospitalization fee window with the rural cooperative card and register online;
3. Register at the hospital registration window with the hospitalization certificate and payment bill to receive medical records and supplies;
4, to the counterpart specialist for hospitalization examination and treatment;
5. When leaving the hospital, find your own competent physician to issue a discharge certificate, a diagnosis certificate and a resident identity checklist;
6. Go through the discharge formalities at the discharge settlement window with the individual payment bill;
7. Submit the settlement bill to the nurse station of the department where you live, retrieve the bed deposit, count the bed units and other items, then take out the settlement invoice at the discharge settlement office, claim the bed deposit, and print the list summary table at the printing office;
8. With the settlement invoice, the original and photocopy of the rural cooperative certificate, the ID card and household registration book, the diagnosis certificate, the checklist of hospitalized patients' identity and the summary list of hospitalization expenses, you can go to the rural cooperative direct subsidy window for reimbursement and receive subsidies.
After the rural medical insurance is reimbursed for hospitalization in different places in this province, it is necessary to open a referral card in the local county rural cooperative medical society. Can rural medical insurance be reimbursed in different places? 1. Generally, it cannot be used across regions;
2, under special circumstances, travel, visiting relatives, vacation and other reasons in different places emergency hospitalization medical expenses, should be reimbursed in accordance with the specific provisions of the local medical insurance measures. Generally, in an emergency, the nearest diagnosis and treatment is allowed. After treatment, with the valid certificate issued by the treatment hospital, the local medical insurance agency will be reimbursed according to the regulations.
3. In addition, if you have retired and your children have settled in Beijing, you can apply to the medical insurance center of the insured area for the relocation of retirees. After you do it well, you can choose one or two designated hospitals in XX, pay the expenses yourself first, and then go back to the medical insurance center where you are insured for reimbursement.
4. For employees who have been overseas for a long time, they can also apply for medical insurance resettlement in different places, and the unit can apply. After the completion, they can choose one or two designated hospitals in XX, pay their own expenses, and then be reimbursed by the medical insurance center in the insured area.
How to reimburse rural medical insurance for medical treatment in other cities in this province? Thank you. How to reimburse rural medical insurance?
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First, what is the new rural cooperative medical system?
The new rural cooperative medical system is organized, guided and supported by * * *, and farmers participate voluntarily, and individuals, collectives and * * * raise funds in many ways. The medical assistance system for farmers is mainly based on serious illness as a whole. Implementing the new rural cooperative medical system is an effective way to help farmers resist the risk of major diseases, an important measure to promote rural health reform and development, and plays an important role in improving farmers' health security level, reducing medical burden, and solving the problems of poverty caused by illness and returning to poverty due to illness.
Two, who can participate in the new rural cooperative medical system?
In addition to the residents who have participated in the basic medical insurance for urban workers, the remaining rural residents should participate in the new rural cooperative medical system where their household registration is located.
Because the cooperative medical system belongs to the nature of mutual assistance, it must be based on the family, and the whole family should participate in the insurance, so as to avoid protecting the big but not the small, and helping the weak and the strong. Primary and secondary school students must participate in cooperative medical care with their families. People who have participated in the basic medical insurance for urban workers cannot participate in the new rural cooperative medical system at the same time.
3. What is the financing standard of the new rural cooperative medical system?
At present, the financing standards of the new rural cooperative medical system in our city are: individual farmers pay annual fees 10 yuan, provincial financial subsidies to 25 yuan, and municipal financial subsidies 15 yuan, totaling 50 yuan.
4. What are the specific provisions for reimbursement of medical expenses (reimbursement scope)?
City * * Office [2003] No.214 and City * * Office [2004] 152, [2005] No.52 and [2006] 186 stipulate the specific scope and proportion of medical expenses reimbursement, not all hospitalization medical expenses.
Reimburseable expenses include:
1, bed fee (the highest is township hospitals 12 yuan/day, and municipal and above medical institutions 15 yuan/day); 2. Drug expenses (the scope of drug use shall be subject to the provisions of the provincial drug catalogue); 3, inspection fees (inspection, testing, etc. , limit 600 yuan); 4. Treatment expenses (settled according to the facts within 300 yuan, and 50% of the above parts in 300 yuan are included in the scope of reimbursement); 5. Surgery fee (charged according to regulations); 6. Blood transfusion fee (the maximum amount of surgery or rescue and hospitalization is in 500 yuan); 7, material costs (the maximum limit of 2000 yuan per hospitalization); 8, all kinds of tumor patients with radiotherapy, chemotherapy and renal failure need dialysis outpatient expenses, as hospitalization expenses for compensation.
5. What is the reimbursement rate?
After excluding non-reimbursable expenses, the reportable expenses are discounted according to different levels of medical institutions: township hospitals in this city 100%, municipal hospitals in this city 90%, outside the city 80%, and 60% without referral certificate. After the discount, the expenses will be settled in proportion: 45% will be reimbursed within 4000 yuan; 400 1-8000 yuan will be reimbursed by 55%; 800 1- 12000 yuan will be reimbursed by 65%; 12001-20,000 yuan will be reimbursed by 75%; More than 20 thousand yuan will be reimbursed 80%. The maximum amount of compensation per person per year shall not exceed 30,000 yuan.
6. What materials are needed for reimbursement of medical expenses? What are the procedures and processes?
(a) the required materials are:
1, original hospitalization invoice; 2. Discharge record; 3, medical expenses list or doctor's advice (provided by the hospital); 4. My identity certificate (copy of ID card or household registration certificate); 5. Others (recommendation certificate, work place certificate, etc.). ).
(2) Procedures and formalities
Patients hospitalized in this city shall directly settle hospitalization expenses in designated medical institutions; For the hospitalization expenses transferred from outside the city, 1 month, the above materials shall be submitted to the handling personnel of township hospitals (joint management office) for settlement, and then sent to the municipal medical insurance office for settlement after preliminary examination.
7. Do I need to go through the examination and approval or registration procedures for hospitalization? How to deal with it?
Participants in the city designated medical service institutions (hospitals) hospitalization without any formalities. However, if it is necessary to go outside the city for treatment due to illness, the attending doctor shall fill in the diagnosis of the disease and the medical institution's medical insurance office shall examine and approve it. Report to the municipal joint management office for reference. The emergency department shall reissue it in accordance with the prescribed procedures within ten days.
Eight, how to reimburse the medical expenses of migrant workers?
Migrant workers in hospital, in addition to providing hospitalization invoices, discharge records, medical expenses list (or doctor's advice), identification, but also need to provide proof of employment in the workplace (which can be provided by the neighborhood Committee or factory in the workplace). Otherwise, according to the proportion of no referral certificate settlement.
Nine, how to stipulate the time limit for reimbursement of medical expenses for cooperative medical personnel?
According to the relevant archives of * * *, the financing and payment of the cooperative medical system in 2007 ended on February 25th, 2006, and the hospitalization expenses of participants from June 65438+1 October to June 65438+February 3rd12007 can be reimbursed according to the prescribed scope and standards. The medical expenses of that year must be settled before the end of February of the following year, and will not be accepted after the deadline.
X. the use and supervision of the new rural cooperative medical fund?
40 yuan, per person 10 yuan and * * * subsidies paid by farmers in the city are all deposited in the municipal finance, stored in special accounts and used for special purposes. The medical expenses of farmers' hospitalization shall be reported to the municipal medical insurance management office for settlement after the township audit. The municipal joint management office (located in the Labor and Social Security Bureau) will supervise the whole process of medical expense reimbursement to ensure that it is carried out in a standardized and orderly manner. All medical expenses and settlement amount should be posted in a prominent position in the township * * * or health centers, subject to the supervision of the masses, so that the masses can understand. We welcome to report fraud in reimbursement of medical expenses.
Rural medical insurance must consult local social security and medical insurance institutions when seeking medical treatment in different places. In terms of referral procedures in different places, local policies are different.
I think, you should be regarded as a work-related injury, and you should apply for work-related injury reimbursement. .
I wish you a speedy recovery.