1, preliminary declaration.

The insured unit or individual who applies for the first time shall, before the last month of each quarter 15, take the Manual of Basic Medical Insurance for Urban Employees in Zhuzhou City (hereinafter referred to as the Manual of Medical Insurance) to the medical insurance department of the first-instance hospital to receive the form, fill out the Application Form for Special Diseases Outpatient of Basic Medical Insurance for Urban Employees in Zhuzhou City, and prepare to declare the relevant medical records (or photocopies) and a recent 1 inch bareheaded photo.

The special declaration of resettlement personnel in different places shall be handled by the medical insurance administrator of the unit or himself in the medical insurance department of Zhuzhou Special Preliminary Appraisal Hospital.

The first-instance hospitals at the same level in Zhuzhou are: the first hospital, the second hospital, the third people's hospital, the third hospital, and the third hospital (only for mental illness).

2. Preliminary examination of the hospital. After the first-instance hospital collects all the relevant information of the applicant, it will organize medical experts in our hospital to make diagnosis and preliminary identification.

3. Expert review. At the end of each quarter, the municipal medical insurance department will organize an expert committee on the basic medical insurance for urban workers in Zhuzhou to conduct centralized review, and the expert committee will examine and approve them one by one according to the special confirmation criteria.

4, the issuance of "special outpatient medical records of special diseases". After passing the review by the Municipal Expert Committee, special applicants will bring the medical insurance manual to the Municipal Medical Insurance Office to receive special medical records for special disease clinics within 5 working days in the first month of the next quarter. Those who pass the review will begin to enjoy the basic medical insurance special disease outpatient treatment that month. If the evaluation by the Municipal Expert Committee is unqualified, it shall indicate the reasons for the unqualified and inform it in writing, and return the medical records to the applicant.

5, special disease renewal procedures. The period of validity of special disease A and B clinics is two years, and that of class C is one year. If the illness is not healed and needs treatment, it is necessary to go through the renewal procedures.

(a) after the expiration of the outpatient treatment of Class A special diseases, go directly to the Municipal Medical Insurance Office for further treatment;

(two) B, C special disease outpatient treatment expires, should be handled according to the original declaration procedures.

Proportion of reimbursement for outpatient settlement of special diseases

Insured patients meet the basic medical insurance policy and belong to special diseases.

The insured pays 20% for drugs and treatment expenses within the maximum outpatient limit, and the basic medical insurance pays 80%; Enjoy the civil service Medicaid personnel, by the civil service Medicaid fund another 5% subsidy; Within the highest standards of mental patients

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.