1. Participants outpatient special chronic disease application information by the city's second-class A or above medical institutions (currently tentative Hancheng City People's Hospital, Hancheng City General Hospital of Mining Bureau) medical insurance section acceptance;
2. Participants in the application for outpatient special chronic disease, you must provide their ID card or social security card copy, 2 2-inch photo, "Hancheng City Urban Workers' Basic Medical Insurance Outpatient Special Chronic Disease Approval Form" (to be obtained from the medical insurance section of the designated medical institution for chronic diseases), and a copy of the complete hospitalization records of hospitals of the second level or above in the past two years.
The insured patients of general diseases need to provide a copy of the complete inpatient medical records of the hospitals of the second level and above in the past two years, a 2-inch bareheaded photo, the insured person will bring the above information to the township health center or community health service center where the account is located to accept the medical insurance section, and the staff of the medical insurance section accepting the chronic diseases will be notified one by one after the feedback of the application information to the township health centers. Currently run for malignant tumors, outpatient radiotherapy, renal failure dialysis, post-transplantation, leukemia, cirrhosis when the compensation period meets the identification criteria for special chronic diseases, simplify the identification process, the insured person directly to the agency to apply for chronic diseases, the next month to enjoy outpatient reimbursement after the examination and approval of the treatment.
Participating residents suffering from major diseases, their hospitalization costs in the current year in the basic reimbursement of residents' health insurance, single or cumulative out-of-pocket expenses exceeding the starting standard for major diseases (10,000 yuan) above the part of the major medical reimbursement, major medical reimbursement costs with the basic medical reimbursement costs of the fixed-point medical institutions in the window of the health insurance a single payment, a one-stop settlement. The maximum limit of hospitalization reimbursement is 150,000 yuan per person per year, and the maximum reimbursement amount of major medical insurance is 300,000 yuan per person per year.
Legal basis
The Chinese People's **** and the State Social Insurance Law
Article 28 The medical expenses that conform to the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as those of the emergency and rescue, shall be paid from the basic medical insurance fund in accordance with the state regulations.
Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.