What to do if you are hospitalized in a different place and not filed within three days

There is a validity period for the record of medical treatment in a different place, usually within three days of hospitalization or before discharge for the record, after the validity period will not be able to reimbursement. If the situation is too urgent to file, you can call the health insurance agency to see if you can file by phone or online. Some regions also provide for emergency hospitalization medical expenses, can not reduce the reimbursement rate, according to the normal enjoyment of health insurance treatment for reimbursement.

First, the foreign emergency how to go to the health insurance

The foreign emergency medical insurance reimbursement is mainly registered for the record, card medical, hospital settlement of the three steps. Specifically as follows:

1, registration: emergency admitted to the hospital within three working days, to participate in the relationship of the health insurance agency, submitted to the admitted hospital issued by the introduction of the condition of the information, including outpatient (emergency) clinic medical records, admission certificates and other materials, for the record registration.

2, card for medical treatment: cross-provincial medical treatment with a social security card, provincial medical personnel should hold a social security card or ID card (household registration and guardian ID card) for admission registration.

3, discharge settlement: when discharged from the hospital, the insured person only need to pay the hospitalization personal out-of-pocket expenses, medical insurance settlement part of the settlement by the medical insurance agency and the designated medical institutions.

Second, the medical card is not with the doctor after the reimbursement

medical card is not with the doctor after the reimbursement, it depends on the actual situation.

If it is to see the emergency or pay hospitalization medical expenses, as long as it is in the social security designated medical institutions, regardless of whether the card with or without the card, can be reimbursed, but also need to advance personal, and then keep the relevant materials, such as the list of medical expenses, diagnostic certificates, etc., and then reimbursement of the health insurance agency. If it is a general outpatient and other out-of-pocket expenses, you can only use the money in the personal account of the health insurance card to pay, if you do not have a card, you can not use the health insurance to pay.

If a participant forgets to bring his or her health insurance card to the hospital during the period of eligibility for hospitalization with normal contributions, he or she can bring the card to the hospital within three days to make up for the hospitalization procedures. Lost health insurance card first lost procedures, and then bring your ID card or household registration to the hospital health insurance management department for registration procedures without a card, and then bring the hospital card and ID card to the municipal social security card management center for emergency card after the settlement with the health insurance card. Hospitals refuse to enjoy the health insurance benefits of the participants with a card for medical treatment, the participants can be directly to the Municipal Health Insurance Center, the Municipal Health Insurance Inspection Office report.

The conditions for reimbursement of medical insurance are as follows:

1, the insured person must go to the designated medical institutions for basic medical insurance to purchase medicines, or with a doctor's prescription issued by the designated hospitals to the designated retail pharmacy identified by the social insurance agency to purchase drugs;

2, the insured person in the process of seeing a doctor in the process of medical treatment incurred in the medical expenses must be in line with the scope and scope of the basic medical insurance insurance catalog of medicines, medical items, medical services and facilities standards.

3. Among the medical expenses incurred by the insured in accordance with the scope of basic medical insurance, those above the starting standard and below the maximum payment limit of the social medical insurance fund shall be paid by the social medical insurance fund in a uniform proportion.

Third, the foreign medical insurance can be reimbursed

foreign outpatient can be reimbursed.

The conditions of the foreign provincial medical conditions foreign resident staff, the company sent on a long-term business trip to work in a different place. But these people have to meet the long-term residence in the field. The children are living in a different place, and the household registration has been moved to the local household registration personnel. If the household registration has been formally moved to the relocation of the employee health insurance coverage, the application for relocation needs to be filed.

Long-term residents, long-term residents in a different place, and in line with the provisions of the insured place, these people need to apply for the resettlement of the insured place for the record, in the inclusion of the medical settlement system in a different hospital hospitalization, with the new social security card to directly settle the medical fees. The participants are eligible for referral, hospitalization, emergency emergency hospitalization and transfer of patients, if because of the condition of the need for foreign medical treatment, and has been issued in the local hospital referral certificate of the patient.

The process of reimbursement of foreign medical insurance is as follows:

1, receive or download on the social security website, "the city's basic medical insurance to work, live in a different place, the situation of the person to declare";

2, fill in the required, and by the foreign social insurance (medical insurance) agencies stamped recognized "declaration form";

3, will be filled out after the "declaration form" back to the division of responsibility for the social insurance agency Audit and confirmation. Have to apply for the province's medical card, after examination and confirmation of the "declaration form" to the municipal social security center audit section for registration, and then to the social security card management section for the province's network of cards for the card-making procedures;

4, for the preparation of the individual social security card can not be used in the use of the insured; insured persons to return to have to be in the medical treatment should be canceled in the municipal social security institutions to the medical preparation of the social security card can only be used in the designated medical institutions from the next day onwards.

5, the implementation of medical reporting changes in the report, no change in the principle of non-reporting.

This article is related to the relevant legal basis

Article 28 of the People's Republic of China Social Insurance Law, in line with the basic medical insurance drug list, diagnostic and treatment items, medical services and facilities standards, as well as emergency, rescue medical costs, in accordance with state regulations from the basic medical insurance fund.