to date

There were 3,343 person-times in the city.

Enjoy the relevant treatment of COVID-19 infection outpatient treatment guarantee.

The medical insurance fund expenditure is 400,000 yuan

The medical insurance card is swiped on the scanner, and the medicine fee is 6 yuan, showing the reimbursement yuan and the individual payment yuan. On June 2, 65438, Ms. Lu, a resident of Gulou Sub-district Office in Yingzhou District, became the first person in our city to enjoy the new policy of reimbursement for outpatient expenses of COVID-19 infection because of COVID-19 infection.

It turned out that Ms. Lu had a low fever and a sore throat because she was infected with COVID-19 virus. She went to the community health service center of Gulou Sub-district Office, and the doctor prescribed a box of medicine for her. When paying, Ms. Lu noticed that the expenses were reimbursed by 70%, which made her feel very warm.

The reporter learned from the Municipal Medical Insurance Bureau

According to the notification requirements of the provincial medical insurance bureau

COVID-19 infection outpatient expenses included in the scope of medical insurance reimbursement.

At present, 259 convenience fever clinics in our city have achieved one-stop settlement.

The designated medical institutions that have opened the settlement service of the basic medical insurance pooling fund are all included in the scope of overall settlement, and the medical category of "COVID-19 Clinic (1 102)" is uniformly used to settle the outpatient expenses of COVID-19 infection, with no deductible and reimbursement limit, and the reimbursement ratio is 70%.

In the case of medical treatment in different places, temporary lack of online settlement conditions, and the need to suspend (stop) the medical insurance settlement system during the cross-year carry-over, the insured patients can apply for manual reimbursement to the medical insurance agency in the insured place with relevant bills;

36 kinds of COVID-19 drugs are temporarily included in the scope of medical insurance payment.

In order to do a solid job in the medical security of infection treatment in COVID-19 in the new stage, strive to ensure health and prevent the occurrence of severe cases, according to the requirements of the Emergency Notice on Doing a Good Job in the Treatment of Infection Outpatients in novel coronavirus, the Municipal Medical Insurance Bureau held a work deployment meeting at the first time, which promoted the policy propaganda, training, system algorithm testing and other aspects to be carried out simultaneously, promoted the implementation of the policy, and made every effort to meet the requirements of "two timeliness and two guarantees". Up to now, 3,343 people in the city have enjoyed the treatment and security related treatment of COVID-19 infection outpatient service, and the medical insurance fund has spent 400,000 yuan.

How to reimburse?

Which medical institutions can be reimbursed?

How to operate?

Here comes the reimbursement guide!

First, the security object

All basic medical insurance participants in the city (basic medical insurance for employees and basic medical insurance for urban and rural residents).

Second, guarantee time and treatment

During the period from February 29th, 2022 to March 29th, 2023, the medical expenses incurred by the insured during the general outpatient (emergency) clinic meeting the requirements of the COVID-19 Diagnosis and Treatment Plan were included in the payment scope of the basic medical insurance pooling fund. There is no deductible and reimbursement limit, and the reimbursement ratio is 70%.

Three, into the designated medical institutions outpatient treatment and security scope.

COVID-19 City's outpatient treatment of infection canceled the restrictions on the settlement level of designated medical institutions. Village clinics (community health service stations), township hospitals (community health service centers), first-class hospitals, second-class hospitals, third-class hospitals and other designated medical institutions that have opened the overall settlement service of basic medical insurance in the whole city are temporarily included in the overall settlement scope of infection clinics in COVID-19.

Fuyang City was listed as an infection clinic in COVID-19.

List of designated medical institutions for treatment and guarantee ***2 176.

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Fourth, the reimbursement settlement method

(1) local reimbursement settlement

The medical expenses of COVID-19 infection clinic in local designated medical institutions shall be reimbursed and settled online immediately. Insured persons can seek medical treatment with medical insurance certificates such as medical insurance electronic certificate, social security card or ID card (limited to insured residents), and the expenses are directly settled in designated medical institutions.

(2) Off-site reimbursement settlement

For temporary business trips and family visits that cannot be settled online due to COVID-19 infection, the insured person can apply for manual reimbursement to the medical insurance agency of the insured place with outpatient medical records and related bills.

Five, the city's medical insurance handling service window address and telephone number.