1. First of all, Yuhuangding Hospital in Yantai can support off-site reimbursement and bring social security cards to the hospital medical insurance office for registration.
2. Secondly, after seeing a doctor, pay the fee at the window of the outpatient charge office and inform the toll collector that it is medical insurance in different places.
Finally, the difference can be settled and reimbursed immediately.
Yantai Secondary Reimbursement Process for Serious Illness
1, where the individual bears the part of compliance medical expenses exceeding 1 ten thousand yuan but less than 1 ten thousand yuan, the compensation shall be no less than 50%; Compensation of not less than 60% will be given to the part of 654.38+10,000 yuan.
2, 20 15 The funding standard for residents' serious illness insurance is 32 yuan per person. In terms of the treatment guarantee of the insured, in 20 15 years, the threshold of residents' serious illness insurance is 1 10,000 yuan, and the compliance medical expenses borne by individuals above the threshold are compensated in stages according to the amount of medical expenses, that is, the compliance part borne by individuals is reimbursed twice after the reimbursement of residents' medical insurance. Individuals shall pay not less than 50% compensation for the compliant medical expenses within the range of 654.38 yuan+100000 yuan to 654.38 yuan+100000 yuan, and not less than 60% compensation for the compliant medical expenses within the range of 654.38 yuan+100000 yuan. The maximum annual compensation limit for an individual is RMB 200,000. Specific compensation standards shall be determined through consultation with the selected commercial insurance institutions.
To sum up, the scope and process of social security outpatient reimbursement Social security medical insurance, that is, basic medical insurance, is generally divided into two parts: pooling funds and personal accounts. The reimbursement scope of different accounts is different, and the reimbursement ratio of different medical expenses is also different.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.