Urban workers' health insurance patients cataract diagnosis and treatment costs can be reimbursed by the medical insurance.
1, urban workers health insurance reimbursement process:
(1) applicant: the patient himself or her spouse, parents, children. If the patient cannot apply in person and does not have a spouse, parent or child, his/her brother or sister shall apply on his/her behalf;
(2) If he/she does not have a brother or sister, the person in charge of the organization shall apply on his/her behalf. If the application is made by the agent, a copy of the agent's ID card and proof of relationship with the patient shall be submitted;
(3) Accepting organization: designated medical institutions below the county level (including the county level, the same hereinafter);
(4) Results of the application: (1) The application for reimbursement of the patient's ID card is true, and the submitted materials are complete, it shall be accepted;
(5) If there is any doubt about the identity documents of the enrolled patients, they shall be transferred to the cooperative medical management agency to verify their identity;
(6) If the submitted materials are not complete, they shall be informed in writing in one go of all the materials that need to be made up.
2, urban workers health insurance reimbursement standards:
(1) outpatient reimbursement standards:
a, the starting line: retiree health insurance reimbursement starting line of 1300 yuan, the starting line of 1800 yuan of active employees.
b, ceiling line: 20,000 yuan;
Reimbursement rate: active employees: 70%; retirees under 70 years old reimbursement of 85%, more than 70 years old reimbursement of 90%.
(2) Hospitalization reimbursement standards:
a, starting line: the first hospitalization at the end of this year starting line of 1,300 yuan, the second and subsequent to 650 yuan each time;
b, cap line: 100,000;
Expanded Information:
Notes on reimbursement for urban workers' health insurance:
(1) The following expenses are not covered: registration fee, out-of-hospital consultation fee, medical records The following expenses are not covered: registration fee, out-of-hospital consultation fee, medical record fee, consultation fee, expedited fee for examination and treatment, surcharge for named surgery, special medical service, health checkup fee; medical consultation, medical appraisal, bed fee, ambulance fee, myopic orthopedic surgery, magnetic therapy, aesthetic plastic surgery, infertility (pregnancy), sexual dysfunction, etc. The health insurance will not be reimbursed;
(2) urban workers' health insurance reimbursement payment: the health insurance for the working people is paid by the health insurance to the unit financial account, and the unit financial payment to me, the retired people will be paid by the unit finance, and the retired people will be paid by the unit finance. The urban workers' basic medical insurance participants, except for those who are resettled in other places, can only be reimbursed for emergency medical expenses incurred in other places during business trips or family visits in accordance with the relevant regulations in Beijing;
b, The person in charge of the unit will go to the district and county medical insurance centers for reimbursement. It is also necessary to submit a statement of the unit's situation regarding the emergency medical expenses incurred abroad (sealed by the unit).
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