1. Xinyang Medical Insurance Reimbursement Process and Required Materials Reimbursement Conditions The conditions for reimbursement are as follows: 1. The applicant has gone through the insurance enrollment procedures and paid the medical insurance premium in full; 2. Seeked medical treatment at a designated medical institution for cooperative medical care; 3. Participated in insurance

If a person incurs hospitalization medical expenses while seeking medical treatment at a registered medical institution, he must pay cash in advance and keep relevant documents and information.

Materials required for application: Individuals must sort out the medical expense documents and related materials in chronological order and submit them to the unit (or social security office) for reimbursement.

1. Original receipt; 2. Hospitalization expense settlement form; 3. Discharge diagnosis certificate; 4. Observation certificate or copy of death certificate; 5. Details of medicines, examinations and treatment expenses, and emergency stay must be stamped with "emergency stamp"

Medical insurance prescription or emergency department emergency prescription; 6. Social security card, "Municipal Medical Insurance Manual"; 7. Hospital full settlement certificate and unit description.

Handling procedures: 1. The handler submits reimbursement documents and other materials to the Shenzhen Insurance Fund Management Bureau for acceptance; 2. The acceptance department receives the application materials, and the medical insurance center completes the review, settlement, and payment on the same day; 3. Social Insurance Fund

The administration will review the materials and approve the application, and the applicant will be reimbursed after receiving the "Social Medical Insurance Medical Expenses Reimbursement Form".

Note: If the application materials are incomplete and all the content needs to be supplemented and corrected by the applicant, the applicant shall supplement and correct the materials within 5 days from the date of receipt of the "Notice of Supplementary and Corrected Materials".

Failure to make corrections within the time limit will be considered as withdrawing the application.

However, after supplementing the materials, the applicant can resubmit the application within the legal validity period.

The applicant will be reimbursed after receiving the "Social Medical Insurance Medical Expenses Reimbursement Form".

2. Xinyang Medical Insurance Reimbursement Ratio and Related Policies Reimbursement Ratio of Medical Insurance Reimbursement Ratio for Active Employees: 1. Only medical expenses of more than 1,800 yuan can be reimbursed after going to the hospital’s outpatient clinic or emergency department, and the reimbursement rate is 50%; 2. If it is 70

For retirees under the age of 1, the reimbursement rate is 70% for expenses exceeding 1,300 yuan; 3. For retirees over 70 years old, the reimbursement rate for expenses exceeding 1,300 yuan is 80%.

Note: Regardless of the type of person, the maximum amount of large-amount medical expenses paid for outpatient and emergency services is 20,000 yuan.

If it is hospitalization expenses, when the basic medical insurance is used for payment for the first time in a year, the minimum payment amount is 1,300 yuan, whether for employees or retirees.

As for the medical expenses for the second and subsequent hospitalizations, the minimum payment standard is determined at 50%, which is 650 yuan.

The maximum payment amount of the basic medical insurance pooling fund (hospitalization expenses) in a year is currently 70,000 yuan.

The standard of hospitalization reimbursement is related to the level of the hospital where the insured person lives: Note: If the insured person lives in a third-level hospital.

1. For expenses from the minimum payment standard to 30,000 yuan, employees pay 15%, which is 85% reimbursement; 2. For expenses from 30,000 yuan to 40,000 yuan, employees pay 10% and 90% is reimbursed; 3. For expenses exceeding 40,000 yuan,

If the amount of expenses reaches the maximum payment limit, 95% can be reimbursed, and employees only need to pay 5%; 4. The proportion of individual payment by retirees is 60% of that of active employees.