1, application time
March 1 to March 15 every year is the time to declare the chronic disease card. Generally, after submitting the application to the medical insurance center, the result will be obtained within 15 working days. An application usually lasts for one year, which does not mean that you will enjoy the subsidy forever after applying, and you have to apply again every year. The application time varies from place to place, so you can consult the medical insurance center.
2, reporting conditions
In China, 25 kinds of diseases are included in the category of chronic diseases, and all of them can apply. Please refer to the latest catalogue of chronic diseases for specific diseases.
Step 3 prepare materials
To apply for a chronic disease card, you need to prepare a social security card, a copy of your ID card, an inpatient medical record, a discharge summary, a diagnosis certificate, and relevant inspection materials. Especially the diagnosis certificate of authoritative hospital, you can't apply for chronic disease card without such certificate, and prepare two recent photos.
Step 4 fill in the application form
The next step is to fill out the application form. If you are an employee, you can ask the person in charge of medical insurance for an application form. If it is residents' medical insurance, you can ask the neighborhood Committee. If it is the new rural cooperative medical system, you can ask for a form and fill it out according to the form.
Step 5 make people obey
Generally, the unit or neighborhood Committee submits the materials, and the results will be available within 15 working days. Eligible people can issue chronic disease cards.
Second, Beijing rural cooperative medical care
1, the payment of cooperative medical care is limited, and it is necessary to go through the payment procedures before the specified deadline.
2. I suggest you consult the local handling department to see if you can go through the formalities according to special circumstances. If not, you can only apply for insurance next year.
Three. Research on reimbursement system of rural cooperative medical care in Beijing
1. For details, please consult the local residents' committee or the local cooperative medical management center. Standards vary from place to place.
2. The following are the reimbursement regulations for the new rural cooperative medical system in Shunyi District, Beijing. Generally speaking, there is little difference between different regions, for your reference:
I. Reimbursement voucher:
1. For reimbursement of general outpatient medical expenses, special receipts, outpatient prescriptions and a list of Beijing outpatient expenses must be provided.
2. Hospitalization reimbursement needs to provide special receipts for hospitalization expenses in Beijing, project details, expense list and diagnosis certificate; For reimbursement of outpatient medical expenses for special diseases, special receipts for outpatient fees in Beijing, outpatient prescriptions, expense lists and corresponding diagnosis certificates must be provided.
3. In the designated tertiary comprehensive medical institutions for hospitalization and special disease outpatient medical expenses reimbursement, should also provide a certificate of referral issued by the designated secondary medical institutions.
Second, the reimbursement standard:
1. The general outpatient department approved medical expenses, and the first-level hospital reimbursed 40%, the second-level hospital reimbursed 30%, and the third-level hospital reimbursed 20%. The actual reported funds were capped at 2,000 yuan.
2. Hospitalization and special disease clinics are approved to reimburse medical expenses, with the deductible line of first-and second-level hospitals being 0 and that of third-level hospitals being 1 1,000 yuan.
Designated secondary medical institutions (except district Chinese medicine hospitals) approved reimbursement deductible to 5000 yuan of medical expenses, reimbursement of 40%; More than 5000 yuan to 20000 yuan, 45% reimbursement; 20 thousand yuan to 50 thousand yuan, 55% reimbursement; More than 50,000 yuan, 65% reimbursement. The upper limit of actual reported funds is 654.38+10,000 yuan.
Third, reimbursement procedures:
Within the prescribed reimbursement time, the participating patients or their families will send the materials such as the certificate of the new rural cooperative medical system, the special receipt for outpatient expenses in Beijing, the outpatient prescription, the expense list or (and) the special receipt for hospitalization expenses in Beijing, the diagnosis certificate, the project details and the expense list to the working group of the new rural cooperative medical system in the village or neighborhood committee.
Four, Beijing rural medical insurance
In 2007:
Policy Answers of New Rural Cooperative Medical System in 2007
1. What are the scope of participants in the new rural cooperative medical system?
Answer: Anyone who has rural residents in agricultural registered permanent residence, residents who have graduated from agricultural registered permanent residence but have not yet joined the work, newborn children whose parents are agricultural registered permanent residence and who are registered in cities and towns, people who have occupied land but have not been employed and have not participated in medical insurance for urban workers can join the cooperative medical system.
Two, in 2007, the new rural cooperative medical fund raising standards compared with 2006, what adjustments?
A: The government subsidy standard has been raised without increasing the burden on farmers, and at the same time, the special needs of special people have been met.
The annual per capita subsidy standard of the municipal finance was raised from 35 yuan to 40 yuan; The per capita subsidy standard of county finance was raised from 20 yuan to 25 yuan; The annual per capita subsidy standard for township finance is raised from 15 yuan to 20 yuan; Farmers' annual payment is divided into three grades: the annual payment per person in the super class is 100 yuan, the annual payment per person in the first class is 30 yuan, and the annual payment per person in the second class is 15 yuan.
3. What is the operation cycle of the new rural cooperative medical system in 2007?
A: From 1 in October 2007 to 1 in February 2007.
4. When and where do farmers who participate in cooperative medical care pay?
A: Farmers participating in cooperative medical care should register and pay fees in their village committees before February 20, 2006.
What adjustments have been made to the scope of reimbursement for medical treatment in designated village clinics?
A: In 2006, 9 pilot township clinics were expanded to 25: Jiayu village clinic in Shicheng town was added; Shidongzi Clinic in Fengjiayu Town and Xikouwai Village Clinic; Xinchengzi Town Garden Clinic; Xiazhazi Village Clinic in Dachengzi Town; Dongshaoqu Town Xihu Road Village Clinic and Dashimen Village Clinic; Bulaotun Town Shi Zhuangzi Village Clinic, Xituogu Village Clinic, Ugly Zishan Village Clinic, yongle village Clinic, Taishitun Town Laowa Village Clinic; Xu Zhuangzi village clinic; Gaoling town Xiadianzi Village Clinic, Xiahe Village Clinic and Tianzhuang Village Clinic.
In 2006, the reimbursement scope of pilot township hospitals was limited to the following chronic diseases on the basis of emergency: cardiovascular and cerebrovascular systems; Hypertension, coronary heart disease; Respiratory diseases: chronic bronchitis, emphysema, pulmonary heart disease; Digestive system diseases: chronic hepatitis, chronic gastritis, gastric ulcer; Urinary system diseases: chronic nephritis; Endocrine system diseases: diabetes
6. What is the reimbursement rate of general diseases in outpatient department?
Answer: When participating farmers go to township hospitals and urban health service centers (stations) for medical treatment with certificates, the hospital will waive the registration fee, medical treatment fee, injection fee and venipuncture fee for participating farmers, and the fees for routine examination of B-ultrasound, electrocardiogram, chest and abdomen fluoroscopy and hematuria will be halved, and the cooperative medical fund will not subsidize them. Medical expenses (within the medical insurance catalogue) are reimbursed for outpatient service, that is, 30% for special files, 25% for first files and 2 1% for second files, which are paid by the cooperative medical fund.
7. What adjustments have been made to the reimbursement standard for outpatient special diseases compared with 2006?
A: With the increase of diseases such as glaucoma and aplastic anemia, the deductible line for cataract and glaucoma has dropped from 1000 yuan to 600 yuan, and the deductible line for special outpatient diseases such as radiotherapy and chemotherapy for malignant tumors, uremia, renal dialysis, anti-rejection drugs after kidney transplantation, leukemia and aplastic anemia has dropped from 2,000 yuan to 1000 yuan; Reimbursement ratio: 60% for special gear, 50% for first gear and 40% for second gear. Top line: 30,000 yuan for special gear, 25,000 yuan for first gear, and 0/0.5 million yuan for second gear.
8. How is the deductible line for reimbursement of hospitalization expenses adjusted?
Answer: In 2006, the deductible line of medical institutions outside the district was 1 1,000 yuan, and the deductible line of secondary medical institutions was 800 yuan; First-class medical institutions deductible line 300 yuan; If the patient is hospitalized with the same disease, the deductible will be reduced only once;
In 2007, the deductible line of medical institutions outside the district was 1 1,000 yuan, the deductible line of secondary medical institutions was 600 yuan, and the deductible line of primary medical institutions was 200 yuan. The deductible is only reduced once a year.
9. What are the scope of reimbursement for hospitalization expenses?
A: In 2007, the reimbursement of nursing expenses was increased.
Will psychiatric patients 10 months and hospitalization in 2007 be reimbursed?
Answer: In 2007, the hospitalization expenses of mental patients were included in the reimbursement: special file 30%, first file 25% and second file 20%. The deductible line and the capping line are the same as those of ordinary hospitalization.
XI。 What are the rules for referral?
A: Those who are hospitalized outside Miyun County and are transferred to municipal public hospitals through secondary hospitals (Miyun County Tuberculosis Prevention and Control Institute) due to emergency or treatment needs will be reimbursed according to the prescribed proportion; Non-emergency cases or county-level hospitals with irregular procedures that have not been referred to other hospitals will be reduced by 50% on the basis of the prescribed reimbursement ratio.