the filing process needs to follow certain regulations and procedures to ensure the accuracy and effectiveness of information.
I. Application conditions for off-site filing
Children's medical insurance off-site filing is usually applicable to the following situations: children need to be transferred to off-site medical institutions for medical treatment due to illness; Children live in different places with their parents or other guardians for a long time; Other circumstances that meet the requirements for medical treatment in different places.
2. Filing application process
1. Prepare relevant materials: including children's medical insurance card, ID card or household registration book, guardian's ID card, relevant certification materials of the place of medical treatment, etc.
2. Go to the social security agency in the insured area: Take the above materials and go to the social security agency or medical insurance window in the insured area for filing application.
3. Fill in the filing application form: Fill in the filing application form as required, including the basic information of the child, the information of the place of medical treatment, the reasons for medical treatment, etc.
4. Submit materials and wait for review: submit the completed filing application form and related materials to the social security agency for review. After the approval, the social security agency will record the information into the system.
III. Procedures for reimbursement of medical treatment in different places
After successful filing, children can be reimbursed for medical treatment in different places according to the following procedures:
1. Seek medical treatment and keep relevant bills: When seeking medical treatment in different medical institutions, all relevant medical bills and prescriptions should be kept.
2. Go back to the insured place for reimbursement: after the medical treatment, bring medical bills, prescriptions, filing certificates and other materials and go back to the social security agency or medical insurance window in the insured place for reimbursement.
3. Waiting for reimbursement: the social security agency or the medical insurance window will review the reimbursement application, and the eligible expenses will be reimbursed according to the specified proportion. Reimbursement is usually paid by bank card or cash.
IV. Precautions
In the process of filing in different places and reimbursement for medical treatment, we should pay attention to the following points:
1. Ensure the accuracy and completeness of the filing information so as not to affect the reimbursement progress.
2. comply with the relevant regulations and procedures of the medical treatment place to ensure the compliance of the medical treatment process.
3. properly keep the relevant bills and supporting materials for subsequent reimbursement.
To sum up:
The purpose of filing children's medical insurance in different places is to protect children's medical security rights when they seek medical treatment in different places. The application process needs to prepare relevant materials and apply according to the prescribed procedures. After successful filing, children can be reimbursed according to the prescribed procedures when they seek medical treatment in different places. In the process of application and reimbursement, we should pay attention to abide by relevant regulations and procedures to ensure the accuracy and compliance of information.
Legal basis:
Article 3 of the Social Insurance Law of the People's Republic of China
stipulates:
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(1) Those that should be paid from the industrial injury insurance fund;
(2) It shall be borne by a third party;
(3) It shall be borne by public health;
(4) seeking medical treatment abroad.
the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.
Article 32 stipulates:
If an individual is employed across the overall planning area, his basic medical insurance relationship will be transferred with him, and the payment period will be calculated cumulatively.