One, the declaration of outpatient severe (chronic disease) required information:
1, the insured person in the last three years outpatient, hospitalization medical records (a must), including discharge records, hospitalization during the examination report card, etc..
2. Individual social security card.
Second, the identification process:
Take the above information to the district health insurance office for initial review, the initial review of qualified issuance of "outpatient critical care identification form", with the completed "outpatient critical care identification form" to the designated hospital for identification. After the appraisal, bring the qualified appraisal form, a photo of myself and a copy of my ID card to the district medical insurance for the relevant procedures.
Three, choose a designated hospital
The approved outpatient critical care (chronic disease) participants can choose a designated hospital for their own medical insurance hospital. When visiting the hospital, the insured person must bring the medical record or approval form with the approval of the Medical Insurance Office for outpatient serious (chronic) diseases. In principle, the fixed-point hospital can only be changed once a year. (Tongji, Xiehe, Provincial People's Hospital and Zhongnan Hospital are not designated hospitals in Wuhan, and they can't be the designated hospitals for choosing outpatient serious illnesses (chronic diseases)).
Four, medication regulations
1, strict implementation of the "Wuhan urban workers basic medical insurance outpatient serious (chronic disease) drug catalog". The medical cost of using Class B drugs or Class B examination and treatment shall be paid by the individual 10% first, and the balance shall be paid by the medical insurance fund according to the proportion of medical insurance. (See the table for details)
2. For the treatment of outpatient severe (chronic) diseases in hospitals, the medicines used shall not exceed the daily prescribed dose, and the medicines carried shall not exceed the 15-day quantity.
3. Medical expenses not related to the treatment of the identified 'outpatient serious (chronic) diseases' shall be borne by the individual.
V. Settlement Methods:
Settlement will be made directly at the selected designated hospitals with social security cards, and the portion of such individual's out-of-pocket expenses will be paid by the individual, while the portion paid by the coordinated fund will be recorded in the hospital (the settlement invoice has been shown).
1, the health insurance policy, at the same time for two and more outpatient serious (chronic) diseases, the annual payment limit for each additional type of disease increased by 2,000 yuan.
2, from the identification of medical expenses incurred after the approval in order to enjoy the outpatient serious (chronic) diseases. The medical insurance fund will not reimburse the appraisal examination fee.
3, the health insurance policy stipulates that simple hypertension and diabetes can not apply for outpatient intensive care, should be combined with complications.