I got my social security card. How can I get reimbursement for medical treatment? What is the process?
The reimbursement process for medical treatment using a social security card:
(1) When seeking medical treatment in a designated hospital, show your social security card to prove your insurance status and registration. , individuals do not need to pay first and then be reimbursed. The social security and the hospital can directly settle the reimbursed part of the social security. Only at the time of checkout, the self-paid part must be paid by the social security card balance or cash.
(2) When reimbursing for hospitalization, there is a deductible (the deductible is generally 10% of the average annual salary of the city’s employees in the previous year), which means that the deductible needs to be paid by yourself. The portion that exceeds the deductible can only be reimbursed according to local social security regulations. The reimbursement ratio varies from place to place, and also varies from hospital to hospital and from project to project. It is about 80%. For details, you can go to the local labor and social security website to learn more.
If a patient holding a social security card needs to go to the hospital to see a doctor after getting sick, the process of going to a designated social security unit with a social security card to see a doctor is as follows: When an insured person falls ill, he or she can go to the hospital with the medical insurance handbook and IC card. Go directly to local designated medical institutions for treatment.
The general procedure is: Hold the medical insurance booklet and IC card--Register with the hospital's Social Security Office--Verify the card--Pay the hospitalization deposit--Hospitalize--For self-pay projects, the patient's consent and signature are required-- The self-payment part of the cash or IC card settlement threshold and self-payment ratio - within the scope of overall planning, will be advanced by the hospital before settlement and discharge.
Note: The settlement of hospitalization expenses adopts a post-paid service project settlement method.
Reimbursement ratio for medical treatment with social security card:
After the application is confirmed, special diseases will enjoy 60% to 80% reimbursement under the monthly limit. The details are as follows:
1. For the use of special medical materials or disposable medical materials with a unit price of more than 1,000 yuan, as well as the installation and replacement of artificial organs, 90% of the basic medical insurance co-ordinating fund will be paid at the domestic universal price;
2. Basic medical expenses for outpatient dialysis for chronic renal failure, outpatient anti-rejection drugs after organ transplantation, outpatient chemotherapy, radiotherapy, interventional therapy or radionuclide therapy for malignant tumors, 90% will be paid by the basic medical insurance co-ordinating fund ;
3. 80% of the outpatient special examination and treatment costs are paid by the basic medical insurance co-ordination fund, and 20% is paid by the individual;
4. Continuous payment is linked to the reimbursement ratio, and the insured person After 2 years of continuous participation in insurance, the reimbursement ratio increases to 71%, after 4 years of continuous participation in insurance, the reimbursement ratio increases to 72%, and so on. How to reimburse for medical treatment with Yangquan social security card
Social medical insurance reimbursement is reimbursed after discharge or transfer to another hospital.
Settlement procedures for hospitalization and outpatient treatment of special diseases:
Before the 10th of each month, designated medical institutions will submit the cost settlement statements, hospitalization settlement statements and related information for patients discharged last month. Report to the medical insurance agency, and after the medical insurance agency audits, it will be used as the basis for monthly pre-allocation and year-end final accounts;
The medical insurance agency will pre-allocate the hospitalization and special diseases of the previous month every month. Coordinated expenses for outpatient treatment;
Insured persons who are identified as suffering from special diseases should go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines. The medical expenses incurred will be directly recorded and settled immediately.
Emergency settlement program: If the insured person is hospitalized in a non-designated medical institution or a medical institution in another place due to emergency rescue, the medical expenses incurred will be paid in advance by the individual or unit. After the emergency rescue is completed, the medical expenses incurred will be paid in advance. Hospital emergency medical records, examinations, laboratory reports, invoices, detailed medical charge lists, etc. will be handled by the medical insurance agency to handle reimbursement procedures in accordance with regulations. How can I re-apply for a social security card or log out?
I can go to the local social security bureau with my ID card to re-apply. If you log out, they will ask you the reason. You cannot log out without a valid reason. . I was working out of town, and my employer paid me social security. When I returned to my hometown to log out of my social security account, I also provided the proof of my employer's social security payment before logging out. I don’t have a social security card, how can I reimburse myself for medical treatment?
Pay for yourself.
Social medical insurance reimbursement is reimbursed after discharge or transfer to another hospital.
Settlement procedures for hospitalization and outpatient treatment of special diseases:
Designated medical institutions will submit the cost settlement statements, hospitalization settlement statements and related information of patients discharged last month before the 10th of each month. Report to the medical insurance agency, and after the medical insurance agency audits, it will be used as the basis for monthly pre-allocation and year-end final accounts;
The medical insurance agency will pre-allocate the hospitalization and special diseases of the previous month every month. Coordinated expenses for outpatient treatment;
Insured persons who are identified as suffering from special diseases should go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines. The medical expenses incurred will be directly recorded and settled immediately.
Emergency settlement program: The insured person is hospitalized in a non-designated medical institution or a medical institution in another place due to emergency rescue. The medical expenses incurred will be paid in advance by the individual or unit. After the emergency rescue is completed, the medical expenses incurred will be paid in advance. Hospital emergency medical records, examinations, laboratory reports, invoices, detailed medical charge lists, etc. will be handled by the medical insurance agency to handle reimbursement procedures in accordance with regulations.
Settlement procedure for relocation of personnel:
For relocation of relocation staff, the unit where they work shall designate 1-2 designated medical institutions in their place of residence and report them to the medical insurance agency for record. ;
The medical expenses incurred by the out-of-town staff who are ill and seek medical treatment at designated medical institutions in their place of residence shall be paid in advance by the person or the employer. After the treatment, the employer shall hold the medical certificate and medical record of the insured person. , valid expense bills, double prescriptions, hospitalization expense lists, etc. must be settled at the social medical insurance agency on the specified date.
Referral transfer settlement:
If the insured person is transferred to other medical institutions for diagnosis and treatment due to limited conditions in designated medical institutions or due to specialized diseases, he must fill in the referral approval form. The treating physician shall put forward the reasons for the transfer, the department director shall put forward the opinion on the transfer, the medical insurance office of the medical institution shall audit, the in-charge dean shall sign, and the transfer shall be reported to the Municipal Medical Insurance Center for approval;
Referral to another hospital In principle, travel within the city first and then outside the city, and first within the province and then outside the province. Referrals within the city are stipulated to be conducted between designated medical institutions. Referrals outside the city must be made by designated medical institutions above the third level in this city;
The medical expenses incurred after the insured person is transferred to another hospital shall be paid in cash by the individual or unit first. After the medical treatment is completed, the medical expenses incurred shall be paid by the insured person. The guarantor or his agent takes the referral approval form, medical record certificate, prescription and valid documents to the medical insurance agency to reimburse the hospitalization expenses that fall within the scope of payment by the overall fund. How to reimburse for medical treatment with social security card in Chengdu.
If it is an outpatient visit, it will not be reimbursed. The money returned on the card every month can be used to buy medicines and pay for examinations. ,
If you are hospitalized, you will be reimbursed directly at the hospital when you are discharged. After applying for a medical insurance card, how do you see a doctor and how do you reimburse?
Generally speaking, areas where medical insurance cards are now convenient have realized real-time settlement between hospitals and medical insurance centers. When paying medical bills, all reimbursable parts have been reimbursed.
As for the reimbursement ratio, it depends on whether the patient is an active employee, whether it is outpatient or inpatient, what level of hospital, what kind of medicine is used, etc. For specific information, please consult your local social security center. How do I apply for a new social security card?
Yes.
You can go to the social security manager of your unit to apply for a card
You can also bring your ID card to the Social Security Bureau to fill out a reissue application;
Entrust someone else to apply , need to provide the identity cards of the principal and the principal. How to reimburse Beijing medical insurance card (social security card)?
Current employees must be over 1,800 before applying
You must use your social security card to register, see a doctor, and get medicine, but there is no such thing as a discount. After reading your medical information, it will be recorded on the card , it was settled on a pro-rata basis at that time, and you only had to pay the out-of-pocket money
You can only apply for designated hospitals, otherwise you will not be charged
The designated hospitals are the five hospitals you selected. And those major hospitals in Beijing that can apply without a social security card. If it doesn't work for others, please tell me how to check the social security card running account
Log in to the website of the local Human Resources and Social Security Bureau and enter the backend of the social security system to check ; Or you can go to the local social security service hall to print the list.
Fanyu.com, the first third-party national human resources exclusive service center, adhering to the slogan of "directly serving employees and completely liberating HR", provides enterprises with employee management, national social security, payroll services, employee Welfare and other special solutions.