With the convenience of transportation, more and more people work from rural areas to cities, which means that some people need to seek medical treatment in different places because of emergencies. In order to reduce the cost of medical treatment, medical insurance reimbursement is needed. First, the medical insurance reimbursement process in different places (1) The insured person brings the discharge summary, invoice, medication list issued by different hospitals and medical certificate issued by the unit to the local social security agency for reimbursement; (two) for hospitalization expenses, medicine fees, etc., you can go directly to the hospital medical insurance office for settlement. Second, how to reimburse medical insurance for social medical insurance means that when workers get sick, social insurance institutions give appropriate subsidies or reimbursement for the medical expenses they need, so that workers can recover their health and labor ability as soon as possible and enter the process of social reproduction. Social medical insurance is an important part of social insurance, which is generally borne by the government. The government will use economic, administrative and legal means to implement and organize. So how to reimburse the insured's medical expenses? Medical insurance is divided into two accounts, personal account and medical insurance card. The money can be used to buy medicine at designated pharmacies, pay outpatient expenses and pay the part of hospitalization expenses that the individual pays. The overall account is managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement are paid by the overall account. When seeking medical treatment (hospitalization), show the medical insurance card to the designated hospital to prove the identity of the insured. At the time of checkout, the part paid by the individual is paid by medical insurance card or cash, and the part reimbursed by medical insurance is settled by medical insurance and hospital, so the individual does not need to pay first and then reimburse. Medical expenses of outpatients cannot be reimbursed. Of course, social medical insurance is reimbursed according to a certain proportion when reimbursed. This reimbursement ratio is mainly divided into the following situations: (1) The reimbursement ratio of different medical insurance in hospitals is different. A person spends 10000 yuan in a hospital. If he is hospitalized in a first-class hospital, 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will be reduced by 2000 yuan first; After excluding "non-medical insurance drug expenses" and "other non-medical insurance expenses", the remaining employees reported 80%, retired or unemployed, and unemployed 50%. (Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are not reimbursed for non-medical insurance purposes.) (II) Proportion of hospitalization medical insurance reimbursement for on-the-job employees. Except for the self-funded part and self-paid 10%, the part that exceeds the hospitalization medical insurance deductible is entitled to the overall payment ratio. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80% (82%/84%/87% in Wuhan), and that for residents is about 70% (80%/65%/50% in Wuhan). Three. How much should I reimburse the local area for medical treatment in other places? (1) The reimbursement rate varies from place to place, and the local regulations shall prevail. The parties concerned may directly consult the local medical insurance office. The medical expenses for medical treatment in different places shall be paid in advance by the individual, and shall be reimbursed by himself or his agent to the medical insurance center after the treatment. (2) The following materials need to be prepared for reimbursement of medical expenses of insured employees: 1, personal medical insurance certificate; A hospital approval document of more than two meters (referral form); 2, stamped by the hospital invoices, cost summary list and discharge summary; 3. The original and photocopy of my or my agent's ID card, and the valid bank card or passbook of the reimbursement personnel.
Legal objectivity:
The Guiding Opinions on Further Improving the Settlement of Medical Expenses for Medical Treatment in Different Places of Basic Medical Insurance stipulates that the hospitalization medical expenses incurred by retirees in different provinces shall, in principle, be paid within the scope specified by the place of residence (including drug list, diagnosis and treatment items and medical service facilities standards); The Qifubiaozhun, payment proportion and payment limit of the medical insurance pooling fund shall, in principle, implement the local medical treatment standard stipulated by the insured place, and shall not be implemented according to the proportion of payment for medical treatment transferred abroad. Upon my application, I can transfer the funds in my personal account to individuals for outpatient medical treatment and medicine purchase.