If the insured fails to go through the referral procedures in time according to the relevant provisions, and the hospitalization medical expenses incurred in non-designated medical institutions outside the city meet the payment scope of the medical insurance fund, they may apply for reimbursement of medical expenses according to the regulations. However, according to the regulations of Shenzhen social medical insurance, the reimbursement rate is reduced by 40%. In other words, only 50% can be reimbursed. However, you can go to a hospital in Shenzhen that is qualified to issue a referral certificate. If approved, it can be reimbursed 90% like Shenzhen. However, if the disease can be diagnosed and treated in this city, it may not be required to be referred outside this city. 2. Any incurable diseases that cannot be diagnosed must be consulted with the tertiary hospitals or municipal specialized hospitals in this Municipality. 3. Critically ill patients who do not need equipment or technology for diagnosis and treatment in tertiary hospitals or municipal hospitals in this city. After the referral, you have to go to the Social Security Bureau for the record before you can go to the hospital where you agree to the referral! Reimbursement requirements: 1. Or accept the original. 2. The social security card of the insured. Certificate of disease diagnosis 4. Original receipt of hospital charges 5. Detailed list of hospital hospitalization expenses. Copy of hospitalization medical records; It needs to be copied in the medical record room of the inpatient hospital and stamped with the official seal of the hospital.
Respondent: Ai Xiaomei XM- Level 3 20 10-5-200 1:56.
It seems that hospitalization is not working. There seems to be no medical insurance connection between Shenzhen and Huizhou. I suggest you ask the social security bureau clearly, because even if you can reimburse in different places, you must report to the social security bureau first.
If you can reimburse, you should pay for it yourself first, and then go back to the medical insurance window of Shenzhen Social Security Bureau with the original document (hospital seal) for reimbursement. Ask the social security bureau questions. If you call, it's 96888.
Seeing your problem, I don't think it's urgent for you to go back to Huizhou for surgery, but the so-called emergency means that your life is in danger and you need emergency rescue. In fact, you should distinguish whether you plan to go back to Huizhou for surgery or worry that something will happen when you travel to Huizhou. This is a completely different concept. The same suggestion is to ask the Social Security Bureau for clarification. In the second case, I strongly recommend that you buy accident insurance, which can give you more protection than social security in the event of an accident.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.