Second, the reimbursement process:
1. Use the name of the newborn when you are hospitalized, and try to avoid using the name of "son of so-and-so" or "daughter of so-and-so"; Inform doctors that they have participated in residents' medical insurance, try to use drugs and treatments in the medical insurance reimbursement catalogue, and use less drugs at their own expense.
2. It is more convenient to use the medical insurance settlement system after the newborn is insured. If there is no insurance, the reimbursement procedure is relatively complicated. Therefore, cash reimbursement should be avoided as much as possible to reduce the burden of submitting materials and occupying funds.
3. If you need cash reimbursement, you should submit the newborn hospitalization invoice, expense list, copy of hospitalization medical records, copy of guardian's ID card, copy of newborn birth certificate and copy of newborn household registration book (home page, index page and newborn personal page) to the local medical insurance office.
4. Newborns need to be hospitalized after being insured. When they are hospitalized, they need to hold the "Certificate of Hospitalization" to the human resources and social security service center of the insured area to issue a certificate without a card, and hand it over to the hospital medical insurance office. When they are hospitalized, they should go through the hospitalization formalities with the certificate without a card. The medical insurance settlement system is used for settlement when leaving the hospital, and only the individual's own part is paid.
Extended data:
Reimbursement process
After the insured residents are hospitalized, they shall pay a certain fee in advance (including Qifubiaozhun and personal out-of-pocket deposit), and the designated medical institutions shall determine the overall payment part and the personal payment part at the time of discharge.
Emergency hospitalization expenses incurred by insured residents in different places due to family visits, vacations and other reasons are included in the scope of medical insurance fund payment. When reimbursing, you need to provide the discharge summary, the first page of medical records, copies of long-term and temporary doctor's orders, hospitalization expenses list, hospitalization documents, disease diagnosis certificate and hospital grade certificate.
Startup area
Xincheng District, beilin district, Lianhu District, Yanta District, weiyang district and Baqiao District (including High-tech Zone, Economic Development Zone, Qujiang New District and Chanba Ecological Zone) will be officially launched from now on; Chang 'an District, Lintong District and yanliang district will be gradually launched before the end of June next year; Gaoling County, zhouzhi county, Huxian County and Lantian were gradually launched in 2009.
Insurance object
Residents' medical insurance is applicable to the following people who are not included in the basic medical insurance for urban workers in Xi: 1. Students in primary and secondary schools (including vocational high schools, technical secondary schools and technical schools) and other children under the age of 18 (including children of migrant workers who have been studying and living in cities with their parents for a long time); 2. Non-employed urban residents with urban household registration in this city and 18 years of age or older.
Payment standard
Children: raised according to the standard of 100 yuan per person per year. Individuals pay 30 yuan and give financial assistance to 70 yuan.
Among them, children who enjoy the minimum living guarantee for urban residents pay 10 yuan and give economic subsidies to 90 yuan; Severely disabled children (holding the Disabled Persons' Card of People's Republic of China (PRC) * * * and above), individual contributions 10 yuan, and economic subsidies to 90 yuan (including employment security fund for the disabled subsidizes 50 yuan).
Urban non-employed residents: raised according to the standard of 250 yuan per person per year. Individual contribution 180 yuan, giving economic subsidies to 70 yuan.
Among them, urban non-employed residents and low-income families over 60 years old who enjoy the minimum living guarantee pay 20 yuan and give financial subsidies to 230 yuan; Non-employed residents with severe disabilities in cities and towns will pay 20 yuan and 230 yuan (including employment security fund for the disabled 150 yuan).
In addition, people who have participated in medical insurance for urban workers can use the surplus funds in their personal medical insurance accounts to pay residents' medical insurance premiums for their immediate family members.
Reimbursement amount
The annual cumulative maximum payment limit of urban residents after insurance (total expenses of serious illness in hospitalization and outpatient service): 35,000 yuan for urban non-employed residents and 40,000 yuan for children. If the insured urban residents have paid for 10 years continuously, the maximum payment limit may be appropriately increased from next year.
Medical expenses higher than the maximum payment limit and beyond the scope of payment of basic medical insurance for urban residents are no longer borne by the overall fund, and can be solved by establishing large medical subsidies and commercial health insurance.
Baidu Encyclopedia-Supplementary Medical Insurance