Before the 10th of each month, the designated medical institutions should be discharged from the previous month's patient's fee statement, hospitalization statement and related data to the medical insurance agency. After reviewing and approving the report, the medical insurance agency will use it as the basis for monthly allocation and year-end settlement;
The medical insurance agency will share the comprehensive costs of the previous month's hospitalization and outpatient treatment of special diseases in advance each month;
Participants who are recognized as suffering from special diseases and go to designated medical institutions designated by the Ministry of Labor and Social Security to seek medical treatment and purchase medicines, and the incurred medical costs are directly credited to the account and settled immediately.
Emergency handling procedures: medical expenses incurred by the insured person for emergency rescue to non-designated medical institutions in the city and non-designated medical institutions abroad shall be prepaid by the individual or the unit. After the emergency rescue is completed, the insured person should take the hospital emergency medical records, test and laboratory reports, invoices and details of medical expenses and other medical insurance agencies to apply for reimbursement in accordance with the regulations.
: a: what is the medical insurance card
Social health insurance card, medical insurance card or medical insurance card or social security card, is a special card for medical insurance personal account. It uses the personal ID card as an identifier, storing details such as personal ID number, name, gender, account funds, and spending. The medical insurance card is borne by the local designated agent bank. It is a multi-functional debit card. After a participating unit pays its contributions, the local health insurance agency commissions the bank at the end of the month to transfer part of the individual account funds to the participating employee's personal health insurance card
(1) When visiting a designated hospital, the health insurance card is presented to prove the participant's identity and registration. Individuals do not need to pay before reimbursement. The medical insurance and the hospital can directly settle part of the medical insurance reimbursement. Only at the time of check-out, the out-of-pocket expenses will be paid by the balance of the medical insurance card or in cash by yourself.
(2) There is a starting line for hospitalization reimbursement (the starting standard is generally 10% of the average annual salary of the city's employees in the previous year), i.e., the portion of the payment line that exceeds the starting line can be reimbursed in accordance with local health insurance regulations. The reimbursement rate varies from place to place, from hospital to hospital and from program to program, and is around 80%, which can be found on the local labor security website.
The settlement of hospitalization expenses is based on postpaid service items.