Luoyang medical insurance policy stipulates that outpatient expenses are not within the scope of reimbursement by the medical insurance pooling fund, and the medical insurance pooling fund only reimburses inpatient medical expenses and outpatient expenses specified by special diseases.

Special disease outpatient reimbursement

Our city will include some diseases that need long-term or lifelong outpatient treatment and have high medical expenses into the scope of outpatient medical treatment for special diseases. There is no Qifubiaozhun for special disease clinics, and the reimbursement rate within the policy scope is 80%, and fixed-point treatment and quota management are implemented.

Special diseases

At present, there are 37 kinds of diseases, and the reimbursement rate of rural poor people for outpatient treatment with an asterisk has increased to 85%.

Insured residents can enjoy outpatient medical treatment for special diseases according to regulations after being identified. According to different diseases, the identification of special disease clinics adopts two ways: centralized identification and non-centralized identification. The centralized identification of special disease clinics is organized by social security agencies, and designated medical institutions conduct centralized identification on schedule; Non-centralized identification of patients, in the designated hospital at any time to apply for identification cards at any time. The specific identification method can be consulted with local social security institutions.

Hospitalization reimbursement conditions

The conditions for reimbursement are as follows:

1. The applicant has gone through the insurance formalities and paid the medical insurance premium in full.

2, cooperative medical designated medical institutions for medical treatment;

3. The medical expenses incurred by the insured in hospitalization in medical institutions shall be paid in cash in advance, and relevant documents and materials shall be kept.