Calculate how much money you can save by applying for health insurance reimbursement, and then calculate how long it takes you to earn that much money and how hard you have to work.
When you compare the two, you'll see that applying for reimbursement from Medicare is really no trouble at all.
Specific details are as follows
1, outpatient treatment: the insured workers are sick, with their social security card to any of the urban workers' basic medical insurance designated medical institutions, outpatient medical fees are paid by the individual account, the shortfall is settled by the individual in cash.
2. Hospitalization: When an insured employee falls ill and needs to be hospitalized, he or she must bring his or her Social Security Card to any urban workers' basic medical insurance designated medical institution to register for hospitalization and pay a certain amount of deposit in advance to pay for the part of the expenses that should be borne by the individual. After the treatment is completed, the medical expenses incurred will be settled in accordance with the relevant policies and regulations of the basic medical insurance for urban workers.
Participating employees' individual accounts pay for
(a) expenses incurred in outpatient clinics of designated medical institutions;
(b) expenses for medicines purchased at designated pharmacies;
(c) expenses that should be borne by the individual for hospitalization in designated medical institutions.
1, designated medical institutions: individual accounts are allowed to be used for the use of medicines outside the Drug List by insured persons at designated medical institutions, the individual portion of inpatient medical expenses, outpatient medical checkups, oral veneers, artificial prostheses such as artificial limbs and eyes, and non-functional orthopaedic treatment; and the cost of preventive vaccinations against Hepatitis B, Rabies, Tuberculosis, and Influenza vaccines, etc. The accounts are also used to cover the costs of vaccination at designated medical institutions. It can also be used to pay for the costs of dispensing orthopedic functional glasses, dental cleaning, registration and decoction of medicines in outpatient clinics and specialized clinics of designated medical institutions. At present, the temporary designation of the dispensing of orthopedic function glasses medical institutions outpatient
2, designated retail pharmacies: you can buy [health] size health care medicines and blood glucose testers, blood pressure monitors, spectrum therapeutic devices and other health care equipment. The required cost is paid by the personal account, and the insufficient part of the personal account is paid in cash. The establishment of individual account pharmacy drug purchase "family **** enjoy" mode, urban workers participating in the basic medical insurance personnel, can voluntarily use the individual account for family members (including spouses, grandparents, grandparents, parents, siblings, children, grandchildren, grandchildren) to pay for the purchase of medicines in the retail pharmacy in accordance with the provisions of the cost.
Is it difficult to get reimbursed by Medicare? Knowing the full process of reimbursement doesn't save you a lot of work!
Retired workers for long-term foreign residence information filing
Processing
Can be handled in the following two ways:
① window: bring your social security card and foreign residence card (or foreign domicile) to the Citizen's Building C, third floor, the health insurance window or district-level health insurance agencies;
② online: log on to the "Human Resources and Social Security Bureau" official website, select the "online business" column, through the "online declaration" to enter the "relocation of the medical declaration
Is it hard to get reimbursed for medical insurance? Know the full process of reimbursement do not know can save a lot of things!
Long-term foreign residents choose to live in a foreign coordinating area in the national hospital hospitalization can directly brush the social security card medical settlement, no longer need to return to the city for reimbursement.
①Long-term foreign residence information for the record after the health insurance card will be suspended in the city of Harbin, personal account funds can be regularly transferred to my social security card bank account, please keep the account in an active state;
②Long-term foreign residence information for the record, once processed for a long period of time. If you want to go back to live or change the city of residence, for a period of one year before the change or cancel the business.
Referral
Certainly due to the city's medical technology, equipment, treatment and other conditions, need to be referred to foreign medical personnel, should be eligible for referral by the designated medical institutions to issue referral procedures and referral information uploaded to the national platform for direct billing, the participant can be selected in the national network of hospitals with a card for medical treatment.
Reimbursement materials
For special reasons can not be directly card settlement of relocation, referral or hospitalization in the field of emergency emergency hospitalization reimbursement of hospitalized persons need to bring the following materials:
① the original medical billing (bill stamps need to be clear and effective);
② summary of the cost of details (stamped with the special seal of the hospital);
③Complete copy of hospitalization records (stamped with the hospital seal);
④Social security card (a copy, check the original).
Is it difficult to get reimbursed for medical insurance? Know the full process of reimbursement do not know can save a lot of things!
Residents' health insurance
Specified medical institutions
1. Hospitalization
Participating residents must hold their social security cards to urban and rural residents' health insurance designated medical institutions to swipe the card to apply for hospitalization registration procedures, diagnosis and treatment of the end of the compliance of medical costs incurred in the hospital immediate settlement, to meet the standards of payment of major medical insurance, while the one-stop settlement in the hospital; the individual only needs to pay Individuals are only required to pay the part of the costs that should be borne by the individual.
2. Special outpatient treatment
Participating residents are required to go to the urban and rural residents' medical insurance special disease outpatient designated medical institutions with their social security cards to declare special disease outpatient treatment according to the type of disease, and then immediately settle the regular medical expenses incurred after the end of the diagnosis and treatment in the hospital, and settle them in the hospital in a one-stop manner if they reach the payment standard of the major disease insurance; individuals only need to pay the part of expenses that should be borne by the individuals. "The individual only needs to pay the part of the cost that should be borne by the individual.
3. General outpatient medical care
Participating residents with their social security cards in the city to determine the general outpatient designated community health centers or township health centers or village health center to choose a general outpatient medical treatment, after the end of the diagnosis and treatment, the occurrence of the compliance of the medical costs incurred in the hospital immediate settlement, individuals need to pay only the part of the cost that should be borne by the individual.
Tuberculosis patients can also choose a designated tuberculosis prevention and treatment center as a designated outpatient medical institution.
Warm reminder: the outpatient hospital for the first time is considered to be the outpatient hospital of the year, and cannot be changed within one natural year after it is determined. Need to re-select my outpatient designated hospital, should be held before December 31 each year with the medical insurance card to other residents of the outpatient coordinated designated outpatient designated hospital to re-select to determine the fixed point; in the prescribed time not to apply for changes in the procedures, should be in the original designated outpatient hospitals to continue to seek medical treatment.
4. Maternity reimbursement
Participating residents must bring their social security cards to the designated maternity medical institutions to apply for hospitalization registration procedures, and the maternity medical expenses incurred after the end of treatment will be settled immediately at the hospital, and individuals will only need to pay the part of the expenses that should be borne by the individual.
5. Reimbursement of outpatient accidental injuries of students and children
The outpatient expenses incurred by insured students and children due to accidental injuries shall be paid by the individual in advance, and after the treatment is completed, the individual shall go to the business outlets in the urban area of Hacienda City, with the reimbursement documents, to apply for reimbursement in accordance with the regulations.
Outpatient medical records, original settlement bills, cost details, the person's medical insurance card (social security card), the person's ID card and bank passbook (card) original and photocopies, the agent also need to provide the agent's ID card original and photocopies.
Long-term application for medical treatment in a different place
Resident in a different place, men over 60 years of age, women over 50 years of age, with their own ID card, social security card, valid proof of residence in a different place, the agent also need to provide the agent's ID card originals and photocopies, to the Municipal Health Insurance Management Center. Apply for long-term medical procedures in a different place, and choose a fixed-point residential area at or above the municipal level as the fixed-point of my different place.
Application for referral from other places
Approved by the designated medical institutions in Hacienda with the qualification of referral due to the need of medical condition and go through the procedures of referral.
Long-term foreign medical treatment and foreign referral medical treatment, settlement (reimbursement)
Residents who have applied for long-term foreign medical treatment and referral procedures, in the selected area of residence or referral to the national network of foreign designated medical institutions, can be held with the social security card for inpatient registration procedures, the end of the diagnosis and treatment of compliance with the medical costs incurred in the hospital instant settlement (reimbursement), to meet the criteria for the payment of the major disease insurance, and at the same time in the hospital "medical insurance" to pay the standard, and the hospital to pay the standard, and to pay the standard. If the standard of payment of major disease insurance is reached, one-stop settlement (reimbursement) can be made in the hospital at the same time; the individual only needs to pay the part of the cost that should be borne by the individual.
Note: If the designated medical institutions in the selected area of residence or the referral to the designated medical institutions do not belong to the national network of designated medical institutions in other places, the hospitalization medical expenses incurred by the insured residents will be paid by the individual first, and after the treatment is completed, the reimbursement materials will be presented to the business outlets of China Life Insurance Company in the downtown area of Hacienda for reimbursement in accordance with the regulations.
Is it difficult to get a medical insurance reimbursement? Knowing the full process of reimbursement does not know can save a lot of things!
The original medical bill, a summary of costs, a complete copy of the medical record (stamped with the official seal of the hospital), my social security card, my ID card and bank passbook (card) original and copy, the agent also need to provide the agent's ID card original and copy. For referrals from other places, the "Application Form for Referral from Other Places for Urban Residents' Basic Medical Insurance" will be provided.
Applications for off-site referrals
If a person is hospitalized in an emergency in a foreign country (excluding overseas), or is hospitalized in a foreign country due to other circumstances, and incurs expenses within the scope of the urban and rural residents' basic medical insurance, he/she will pay the expenses in advance, and then go to the business branch of China Life Insurance Company in the urban area of Hacienda City with the reimbursement materials for reimbursement in accordance with the regulations after the end of the treatment.