The latest policy for reimbursement of out-of-town medical insurance in 2017 1. Conditions for reimbursement of out-of-area medical insurance 1. Insured persons who have gone through the registration and filing procedures for out-of-town medical treatment such as placement in another place, visiting relatives, working and studying abroad, etc., will receive cash advance payment for medical expenses incurred at designated medical institutions in out-of-area medical insurance
situation.
2. The situation where provincial-level insured persons transfer to Beijing and Shanghai medical insurance designated medical institutions for medical treatment with cash advance upon approval.
2. Reimbursement ratio of medical insurance in other places (up to 90%) 1. Outpatient reimbursement ratio There is no deductible for ordinary outpatient clinics. All insured residents enjoy the treatment of ordinary outpatient clinics.
Within a medical insurance year, there is no deductible for general outpatient services. Medical expenses within the payment range of the outpatient overall fund are reimbursed at a rate of 60%. The maximum annual personal payment limit of the overall fund is 400 yuan.
2. Hospitalization reimbursement ratio.
The longer the continuous insurance period, the greater the reimbursement ratio. For every 5 years of continuous payment by insured residents, the hospitalization reimbursement ratio of the medical insurance fund will increase by 5 percentage points, and the total will not exceed 10 percentage points.
If you participate in the insurance for 10 consecutive years from 2007, the hospitalization reimbursement ratio in third-level, second-level, and first-level hospitals will reach 70%, 80%, and 90% respectively.
3. Secondary reimbursement ratio. After "secondary reimbursement", there may be "reimbursement". Among the medical expenses incurred by insured residents for a single hospitalization, the part that falls within the payment scope of the urban residents' basic medical insurance co-ordinating fund will be included in the basic medical insurance co-ordinating fund.
After proportional payment, if the personal burden exceeds 8,000 yuan, the excess portion will be "secondary reimbursed" at a rate of 55% from the critical illness insurance funds.
3. Process for reimbursement of medical insurance in other places 1. Receive or download the "Municipal Basic Medical Insurance Declaration Form for Persons Working and Living in Other Places" (hereinafter referred to as the "Declaration Form") on the social security website; 2. Fill it out in accordance with regulations and submit it to the social insurance company in other places.
The "Declaration Form" stamped and certified by the (medical insurance) handling agency; 3. Return the completed "Declaration Form" to the responsible social insurance handling agency for review and confirmation.
If you need to apply for a medical card in another place in the province, after verification and confirmation, go to the Audit Department of the Municipal Social Security Center with the "Declaration Form" to register, and then go to the Social Security Card Management Department to go through the card production procedures for the province's off-site network card; 4. After filing
The personal social security card of the insured person cannot be used anymore; if the insured person needs to seek medical treatment when he returns, he should go to the municipal social security agency to cancel the medical registration, and his personal social security card can only be used in designated medical institutions from the next day; 5
. The principle of reporting any changes to medical reporting is implemented, and not reporting if there are no changes.