I. Enrollment (non-unit insured flexibly employed persons as an example, the unit's do not have to run on their own)
1, declaration, registration: flexibly employed persons with their original ID card and a copy of the city health insurance bureau for early reporting and registration procedures. After examination and qualification, the medical insurance card, card and special office book for everyone.
2. Approval of contributions: the Municipal Medical Insurance Bureau, based on the declaration and registration of flexibly employed persons, approves and fills in the Approved Statement of Contributions in accordance with the regulations.
3. Payment Procedures: Flexibly employed persons holding the Approved Payment Slip stamped by the Municipal Medical Insurance Bureau will go directly to the Taxation Hall of the Municipal Local Taxation and Collection Bureau to pay the fees. The bill is transmitted from the Municipal Local Tax Collection Bureau to the Municipal Labor Settlement Center, and the Municipal Labor Settlement Center to the Municipal Medical Insurance Bureau. The Municipal Medical Insurance Bureau regularly transmits to the Labor Clearinghouse once a month the approved data on the contributions of flexibly employed persons.
The process of medical treatment
(1) Hospitalization
1. Holding the Medical Insurance Certificate and the Medical Insurance Card (the certificate and the card must be complete), you can go to the designated hospital and pay the outpatient registration fee for outpatient treatment.
2. The treating doctor will record the main conditions, examination (test) results and treatment in the "Medical History and Treatment Record" of the medical insurance card; if the patient needs to be hospitalized according to his condition, the treating doctor will issue a hospitalization certificate.
3. You can register your application for hospitalization by bringing your Medical Insurance Certificate, Medical Insurance Card and Hospitalization Certificate to the Medical Insurance Charges (Admission Registration Office) of the designated hospital, and the hospital will transfer the information of your application for hospitalization to the Medical Insurance Bureau on the Internet (the Medical Insurance Certificate and Medical Insurance Card will be left at the hospital's Admission and Discharge Office).
4. Those who are hospitalized in the County People's Hospital will go to the business hall of the Medical Insurance Bureau (opposite to Mao Zedong's former residence in the County People's Hospital, Tel: 6219561) with their hospitalization cards, unit introduction letters, inspection report forms and laboratory test information for approval of hospitalization; those who are hospitalized in other hospitals in the county will have their hospitalization cards and inspection (test) information faxed by the hospitals to the business hall of the Medical Insurance Bureau, which will approve the application online, and the patients will not need to go to the Medical Insurance Bureau to go through approval procedures. Patients do not need to go to the Medical Insurance Bureau for approval procedures; emergency patients who are too late for hospitalization approval procedures can be hospitalized first, and then make up for the hospitalization approval procedures within three days.
5, to the hospital admission and discharge settlement office to pay a certain amount of hospitalization deposit, medical costs within 1,000 yuan by the full amount of the deposit, the medical cost of more than 1,000 yuan part of the deposit at 50%. For medical expenses incurred during hospitalization, medical expenses below the starting standard of the medical insurance fund (referred to as "self-payment section"), the part to be borne by the participant and the unit, and the part of self-paid medicines and out-of-pocket expenses shall be settled by the participant with the hospital in cash, while the part of medical expenses to be paid by the medical insurance fund (i.e., reimbursable part) shall be credited by the hospital and the hospital shall pay for the part of expenses. (i.e. the reimbursable part of the medical fee) shall be recorded by the hospital and settled between the hospital and the medical insurance bureau; the minimum starting standard of the medical insurance co-ordination fund (referred to as the "out-of-pocket payment section") is as follows: for the first hospitalization in the county, RMB 500 for the first level medical institution (township hospital), RMB 600 for the second level medical institution (county hospital), and RMB 700 for the third level medical institution and the medical institution transferred out of the county. For the second hospitalization, 80% of the starting payment standard for the first hospitalization; for the third or more hospitalizations, 60% of the starting payment standard for the first hospitalization. The hospitalization deposit will be refunded in accordance with the settlement of the bill at the time of discharge.
6. If special examination and treatment is required during hospitalization in the People's Hospital of the county (a single examination and treatment item exceeding RMB 100 yuan or including RMB 100 yuan), the treating doctor shall issue the "Approval Sheet for Special Examination and Treatment", and the head of the hospital department and the dean of the hospital shall sign and agree to it for approval by the Medical Insurance Bureau; and if the patient is hospitalized in other hospitals of the county, the hospital shall submit the "Approval Sheet for Special Examination and Treatment" to the Medical Insurance Bureau for approval by the hospital. The hospital will fax the "special examination and treatment approval form" to the business hall of the Medical Insurance Bureau, and the Medical Insurance Bureau will approve the form online, so the patient does not need to go to the Medical Insurance Bureau for approval; emergency patients who are too late to go through the approval procedure can be examined or treated first, and then make up for the approval procedure of the special examination and treatment within three days.
7. When patients are discharged from the hospital, they will go to the Hospital Admission and Discharge Settlement Office for discharge settlement, return the overpaid hospitalization deposit or make up for the underpaid fees; they will receive the settlement bill printed by the hospital (unit reimbursement coupon) and retrieve the Medical Insurance Certificate and Medical Insurance Card.
8. When the insured person suffering from difficult and serious diseases cannot be treated in the hospitals in the county and needs to be transferred to another hospital, the doctor in charge of the hospital shall fill in the "Approval Form for Transferring to Another Hospital and Referring to Another Hospital", and the section chief and the director of the hospital shall agree to the transfer after signing, and then he/she shall hold the "Medical Insurance Certificate" and "Medical Insurance Card", the introduction letter of the unit, the medical information such as examination and laboratory test, and the "Approval Form for Transferring to Another Hospital and Referring to Another Hospital" issued by the hospital. The "hospital transfer approval form" to the Medical Insurance Bureau business hall for hospital transfer procedures, after approval can be transferred to a higher hospital for treatment, emergency patients can be reported by phone first after the transfer of hospitals, within three days to make up for the transfer of hospitals and referrals approval procedures.
(2) outpatient
This is not quite the same everywhere, but as long as you bring the social security health insurance government, health insurance card, tell the doctor when you see a doctor that you have health insurance can be
Extended reading: how to buy insurance, which is good, hand in hand to teach you to avoid the insurance of these "pits"