Children who are not Changsha City household registration, nor Changsha City school registration, can not participate in urban and rural residents' medical insurance.
"Trial Measures for Changsha Basic Medical Insurance for Urban Residents"
Article 4: Urban residents' medical insurance covers students in primary and secondary schools (including students in vocational high schools, junior colleges and technical schools), children and teenagers, and other non-employed urban residents who are not covered by the basic medical insurance system for urban workers in Changsha city (including urban villagers who are not covered by the new type of rural cooperative medical care). Urban villagers, hereinafter referred to as the insured), specifically divided into:
(a) primary and secondary school students, children and adolescents (hereinafter referred to as minors);
(b) 18 years of age but not yet 60 years of age of the age group of non-employee residents (hereinafter referred to as non-employee residents);
(c) 60 years of age and above (hereinafter referred to as elderly residents).
Are you enrolled in the Resident Medical Insurance? If you are enrolled in the medical insurance, you can be reimbursed directly for hospitalization. If you are on outpatient dialysis, you can apply for a chronic disease clinic, the state team needs dialysis patients are very caring, some places for chronic disease clinic, dialysis is free of charge, all the way to the health insurance costs, no longer charge you money. In some places, the reimbursement rate is so high that a dialysis session may only cost a few tens of dollars.
You can go to your local social security department and ask about the procedures for chronic disease outpatient clinics
Starting line: Hospitalization costs need to exceed a certain amount before the medical insurance fund will reimburse you, and this amount is called the starting line
Urban residents' medical insurance has set different starting standards for hospitalization and the fund's payment ratio according to different hospital levels
Hospitalization Starting standard fund payment ratio
Tertiary hospital 700 yuan 50%
Second-level hospital 400 yuan 60%
First-level hospital 200 yuan 70%
Community health institutions 100 yuan 70%
Calculation of hospitalization reimbursement
Hospitalization reimbursement = (total hospitalization cost) -starting line - out-of-pocket medicines and items)
Fund payment ratio
For example: a participant was admitted to a tertiary care hospital due to illness, and incurred medical expenses*** amounting to 15,000RMB, of which out-of-pocket medicines and items amounted to 1,000RMB
Medicare reimbursement amount is as follows: (total expenses 15,000RMB) The reimbursement amount is: (total cost 15000 yuan - starting line 700 - out-of-pocket medicines and items 1000 yuan) X 50% = 6650 yuan
Medical expenses incurred in Changsha Urban Residents' Medical Insurance designated hospitals will be reimbursed directly at the time of hospital billing by presenting the medical insurance card, ID card, school certificate or student ID card. The medical insurance card, the original ID card and a copy of the original hospitalization invoice, a summary list of medical expenses, a summary of the discharge or discharge diagnostic certificate, and a certificate of the type of hospital charges will be handed over to the university in which they are located, and the university will submit it to the municipal medical insurance center for reimbursement
The general hospitals and the medical clinics at the schools are