1. Insure (take the flexible employees who are not insured by the company as an example, and those who are employed by the company don't have to run by themselves)
1. Declare and register: The flexible employees go to medical insurance bureau for the morning paper and registration with the original and photocopy of their ID cards. After passing the examination, apply for everyone's medical insurance certificate, card and special office.
2. Approved payment: According to the declaration and registration of flexible employees, medical insurance bureau will be approved according to the regulations and fill in the Payment Approval Form.
3. Payment procedure: Flexible employees hold the Payment Approval Form stamped with the special seal of medical insurance bureau, and pay directly at the tax hall of the local tax collection bureau. The fee ticket is transmitted to the municipal labor settlement center by the municipal local tax collection bureau, and the municipal labor settlement center is transmitted to medical insurance bureau. Medical insurance bureau regularly transmits the payment verification data of flexible employees to the labor settlement center once a month.
second, the process of seeking medical treatment
(1) hospitalization
1. Go to the designated hospital to pay the outpatient registration fee with the Medical Insurance Certificate and the Medical Insurance Card (the required certificates and cards are complete).
2. The attending doctor records the main illness, examination (inspection) results and treatment in the "Medical Insurance Certificate"; Patients who need to be hospitalized according to their illness shall be issued a hospitalization certificate by the attending doctor.
3. Send the Medical Insurance Certificate, the Medical Insurance Card and the Hospitalization Certificate to the designated hospital's medical insurance charge (admission registration office) for registration, and the hospital will upload the hospitalization application information to the medical insurance bureau online (the Medical Insurance Certificate and the Medical Insurance Card are left at the hospital's entrance and exit).
4. The inpatients in the county people's hospital shall go through the hospitalization examination and approval procedures with the hospitalization certificate, unit introduction letter, inspection report and laboratory data in the business hall of the medical insurance bureau (opposite to the former residence of Mao Zedong in the county people's hospital, tel: 6219561); In other hospitals in the county, the hospital will fax the hospitalization certificate and inspection (inspection) data to the business hall of the medical insurance bureau, and the medical insurance bureau will approve it online. Patients do not need to go to the medical insurance bureau for examination and approval procedures; Emergency patients who have no time to go through the hospitalization examination and approval procedures can be hospitalized first, and the hospitalization examination and approval procedures will be completed within three days.
5. Pay a certain hospitalization deposit at the hospital entrance and exit settlement office. Pay the deposit in full if the medical expenses are within 1 yuan, and 5% if the medical expenses are above 1 yuan. Medical expenses incurred during hospitalization, medical expenses below the Qifubiaozhun of the medical insurance pooling fund (hereinafter referred to as "self-payment section"), the personal burden and unit burden of the insured, self-funded drugs and self-funded expenses shall be settled by the insured in cash with the hospital, and the medical expenses paid by the medical insurance pooling fund (that is, the medical insurance reimbursable part) shall be accounted for by the hospital, and settled by the hospital and the medical insurance bureau; The minimum qifubiaozhun of medical insurance pooling fund (referred to as "self-payment period" for short) is: the first hospitalization in the county, the first-level medical institution (township hospital) in 5 yuan, the second-level medical institution (county-level hospital) in 6 yuan, the third-level medical institution and the medical institution outside the county in 7 yuan; The second hospitalization is 8% of the first hospitalization Qifubiaozhun; The third hospitalization is 6% of the first hospitalization Qifubiaozhun. When the hospitalization deposit is discharged from the hospital, it will be refunded more and replenished less according to the settlement.
6. If special examination and treatment are needed during hospitalization in the county people's hospital (referring to a single examination and treatment project exceeding 1 yuan and 1 yuan), the attending doctor will issue a "special examination and treatment approval form", which will be approved by the medical insurance bureau after being signed by the director and dean of the hospital department; In other hospitals in the county, the hospital will fax the "special examination and treatment approval form" to the business hall of the medical insurance bureau, and the medical insurance bureau will approve it online. Patients do not need to go to the medical insurance bureau for examination and approval procedures; Emergency patients who have no time to go through the examination and approval procedures can be examined or treated first, and the examination and approval procedures for special examination and treatment will be completed within three days.
7. When the patient leaves the hospital, he/she will go to the hospital's entry-exit settlement office for discharge settlement, and return the overpaid hospitalization deposit or pay the underpaid fee; Get the settlement documents printed by the hospital (reimbursement form of the company) and get back the Medical Insurance Certificate and Medical Insurance Card.
8. When the insured person is unable to be diagnosed and treated in the county hospital and needs to be referred to another hospital, the attending doctor of the hospital will fill in the "Approval Form for Referral to Other Hospitals", and after the director and dean of the department sign the opinions, they will go to the business hall of the Medical Insurance Bureau to handle the transfer and referral procedures with the Medical Insurance Certificate, the Medical Insurance Card, the letter of introduction from the unit, the examination and laboratory data and the "Approval Form for Referral to Other Hospitals" issued by the hospital, and after approval.
(2) Outpatient service
This place is different, but as long as you bring the social security medical insurance policy and medical insurance card, you can tell the doctor that you have medical insurance when you see a doctor.
Read more: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.