I. The materials for children to apply for medical insurance are as follows:
(1) identification: provide the original and photocopy of the household registration book and ID card (the photocopy of the household registration book includes the first page of the household name and the current page of the insured);
(two) fill in the "urban residents basic medical insurance payment declaration form" in duplicate (to the insurance registration department to receive or visit the local social insurance fund management center website to download);
(3) If it is necessary to pay by bank transfer, provide the original and photocopy of the savings card or current passbook of any resident medical insurance payment bank, and the original and photocopy of the ID card of the head of household corresponding to the savings card or passbook, and fill in and sign the Authorization Letter for Entrusting the Bank to Pay Social Insurance Fees by Automatic Transfer (get it from the affiliated insurance registration department) according to the prescribed format.
Second, what is the specific proportion of children's medical insurance reimbursement?
(1) Hospitalization medical insurance benefits. Within one year, the first-class hospital (community health service center) will not set the deductible line for hospitalization medical expenses below 6.5438+0.8 million yuan, and will be reimbursed 65%; 300 yuan, the deductible line of the secondary hospital, reimbursed 60%; 500 yuan, the deductible line of tertiary hospital, will be reimbursed by 55%.
(two) outpatient special disease reimbursement treatment. The deductible line for outpatient special diseases within one year is 300 yuan, and the highest payment limit and reimbursement ratio are implemented according to the hospitalization reimbursement standard.
(3) Emergency reimbursement. In a year, the deductible line of emergency medical expenses incurred by urban and rural residents in a first-class hospital is 800 yuan, with the maximum payment limit of 3,000 yuan and 30% subsidy.
(4) Additional insurance benefits for students' accidental injuries. On the basis of the basic medical insurance for urban and rural residents, a unified supplementary insurance for accidental injuries of students and children will be established to solve the problems of medical expenses compensation, disability and death subsidies for students and children due to accidental injuries.
Within one year, the first-class hospital (community health service center) will not set the deductible line for hospitalization medical expenses below 6.5438+0.8 million yuan, and will be reimbursed 65%; 300 yuan, the deductible line of the secondary hospital, reimbursed 60%; 500 yuan, the deductible line of tertiary hospital, will be reimbursed by 55%.
Students and children incurred medical expenses of less than 6,543,800 yuan+0.8 million yuan in a settlement year. The threshold for tertiary hospitals is 500 yuan, and the reimbursement rate is 55%. The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%. There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Article 25 The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.