1, go to the designated medical insurance hospital for medical treatment;
2, to the corresponding clinic, and take the initiative to inform the doctor to participate in residents' medical insurance, or employee medical insurance;
3. Go to the hospital charging window and tell the toll collector that this clinic needs to be included in the medical insurance reimbursement;
4. Settle in the medical insurance window and pay in the charging window.
The materials to be submitted for medical insurance reimbursement are as follows:
1, original ID card or social security card;
2. Original disease diagnosis certificate issued by tertiary or secondary hospitals of designated medical institutions;
3, outpatient medical records, inspection, test results report and other original medical information;
4. Original receipt of outpatient charges of medical institutions with unified finance and taxation;
5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;
6. Designated pharmacies: unified original invoices and computer-printed sales lists of taxable goods;
7. If acting as an agent, provide the original ID card of the agent.
To sum up, take all the above information to the relevant departments of the local social security center. Upon examination, if the information is complete and meets the requirements, it will be handled immediately. When applying for reimbursement of outpatient medical expenses, the applicant should first deduct the amount allocated to the personal account of medical insurance in this social security year, and then verify the amount to be reimbursed.
Legal basis:
Article 29 of People's Republic of China (PRC) Social Insurance Law
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.