Medical insurance reimbursement in different places needs to meet certain conditions: first, referral outside the city needs approval; Secondly, if an employee's medical insurance insured person goes to a different place for medical treatment for a short or long time (more than 3 months), he should first go through the registration procedures for medical treatment in a different place at the Municipal Social Security Bureau and go to a designated medical institution for medical treatment; Third, sudden emergencies in different places can also be reimbursed. The materials required for reimbursement include hospital medical records, expense lists, original medical expense vouchers, discharge certificates, etc. The reimbursement ratio varies according to the range of expenses. Generally, 88% of the threshold fee is above 3,000 yuan, 90% is above 3,000-5,000 yuan, 92% is above 5,000-10,000 yuan, and 95% is above the maximum payment limit. Pay special attention to the low reimbursement rate of class B drugs and expensive drugs. When handling reimbursement, you can entrust others to handle it on your behalf.
Medical insurance cross-provincial medical treatment process;
1. Handling medical records in different places: patients need to submit an application for medical records in different places to the medical insurance management department of the insured place;
2. Submit relevant materials: including ID card, medical insurance card, insurance certificate, description of illness, etc.
3. Pending approval: the medical insurance management department will review the submitted materials and approve those that meet the requirements;
4. Go to a registered hospital for medical treatment: after the patient goes to a different place, go to a registered hospital for medical treatment;
5. Settlement of medical expenses: After the patient goes to the hospital, the expenses shall be settled according to the medical insurance policy;
6. Reimbursement procedures: patients need to bring medical invoices and related materials to the medical insurance management department of the insured area for reimbursement procedures.
To sum up, college students' medical insurance in different places can be reimbursed, but certain conditions need to be met, including approval, registration of medical treatment in different places, and medical treatment in designated medical institutions. The materials required for reimbursement include hospital medical records, expense lists, original medical expense vouchers, discharge certificates, etc. The reimbursement ratio varies according to the expense interval, but the reimbursement ratio of Class B drugs and expensive drugs is low. In addition, you can entrust others to handle reimbursement.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.