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Scope of reimbursement for student medical insurance card
1. Take the medical insurance card and medical records with you when you go to the school hospital. For the first time, I didn't apply for medical records, but went to the infirmary (provided my 1 inch photo and medical insurance card).
2. If you need to go to an off-campus hospital, you must first sign a referral opinion from the attending physician of the school hospital before you can go to a designated hospital. Those who recommend themselves without approval will not be reimbursed for all expenses.
3. Materials to be prepared for reimbursement:
Medical record book, referral record of attending doctor in school hospital, medical insurance card, medical record of referral hospital, expense list, auxiliary examination results (original and photocopy provided above), and original invoice.
4. The college only reimburses the general outpatient expenses that meet the requirements and participate in medical insurance in our school.
Reimbursement is proportional, with ups and downs. The part exceeding the price limit shall be reimbursed according to a certain proportion after deducting various self-funded items. There is also a capping line, and the annual reimbursement amount does not exceed this capping line. Now students are running cooperative medical care for residents, and generally about 30% of them are reimbursed. When you show your medical insurance card to the hospital and register, you can usually reimburse it when you leave the hospital. If you use less self-funded drugs, the reimbursement ratio can be higher accordingly.
How to use the student medical insurance card?
1. Before hospitalization or after discharge, use the medical insurance card to swipe the card directly at the hospital payment office. The system will directly settle the self-payment ratio and print the list.
2. Application scope of student medical insurance card: tertiary hospitals, secondary hospitals, primary hospitals and community health service centers.
3. What diseases are covered by the medical insurance card: special diseases in hospitalization and specialist outpatient service.
4, where the transfer of medical treatment, medical treatment in different places of insured patients to apply for reimbursement of hospitalization medical expenses, need to provide the following materials:
①IC card (medical insurance card);
② Invoice of hospitalization medical expenses;
③ Disease diagnosis certificate (stamped with special seal for disease certificate);
(4) Summary table of detailed classification of hospitalization medical expenses (stamped with special seal for charges);
(5) copy of long-term doctor's advice (stamped with special seal for medical record room);
6. Copy of short-term doctor's advice (with special seal for medical record room);
⑦ Discharge summary (stamped with special seal for medical record room);
(8) Reimbursement of the agent's ID card;
Pet-name ruby xx province basic medical insurance for medical treatment in different places insured hospitalization inspection list.
Or, after hospitalization, issue the disease certificate issued by the hospital and the certificate issued by the school, bring the medical insurance card and the above two certificates to the medical insurance center, open a unified medical card in the whole province, and then swipe the card directly to the affiliated hospital for treatment.
5. Students who have applied for medical insurance cards will no longer issue cards, and the original medical insurance cards can be used directly.
College students' medical insurance related knowledge
I. Necessary materials for medical reimbursement:
Original invoice, medical record, general list of expenses (which must be stamped with official seal), certificate of institutions (certificate of participation, certificate of accidental injury or certificate of hospitalization in different places) and other materials.
Second, outpatient reimbursement data:
1. Accidental injury of the person without responsibility (the "detailed course of injury" must be stated, and the College will issue the "Accidental Injury Certificate" (with the official seal of the College). The "detailed injury process" should be clear: who, when, where and why what kind of injury happened.
2, outpatient illness (malignant tumor radiotherapy and chemotherapy, leukemia radiotherapy and chemotherapy, uremia kidney dialysis needle, organ transplantation anti-rejection treatment, psychosis, tuberculosis, hemophilia ***7 kinds of outpatient illness). Application process of outpatient service for serious illness: I apply to the Municipal Medical Insurance Office, fill in the application form for outpatient service for serious illness subsidy, submit the patient's hospitalization medical records and copies of relevant inspection and laboratory reports in designated hospitals above Grade II in the past year, and submit them to the Municipal Medical Insurance Office in the first month of each quarter (1- 10), and issue a medical certificate for outpatient service for serious illness after being examined and approved by experts. Patients can go to designated hospitals for outpatient treatment.
Three, hospitalization reimbursement data:
1, local hospitalization: those who are hospitalized in local designated hospitals due to diseases or injuries of persons without responsibility can be reimbursed directly on the hospital network. The specific process is: on the first day of hospitalization, bring the patient's ID card to the medical insurance department of the hospital for filing, and reimburse it directly at the hospital when leaving the hospital.
Note: From now on, materials that can be reimbursed in designated medical insurance hospitals but cannot be directly reimbursed in hospitals will no longer be accepted by the Municipal Medical Insurance Office, and materials will not be reimbursed.
2. Hospitalization in different places: If you are hospitalized in a designated medical institution outside the school, you can also reimburse the tape bag after discharge. Among them, the original invoice, copy of hospitalized cases, total cost list, college certificate and other materials are needed in winter and summer vacations; At other times, when in hospital, you should fill in the Registration Form for Emergency Hospitalization of Medical Insurance, and report it to the medical insurance window of urban residents for the record. Materials that are not filed in time will not be accepted by the municipal medical insurance department from now on.
Fourth, receive the reimbursement form:
After the reimbursement form is issued, I need to bring my ID card, UnionPay card and reimbursement form to the No.8 window on the first floor of Taian Social Service Security Center to collect the money. If you can't go in person, you can also find someone to act as an agent (the agent needs to bring the agent's ID card, reimburse my ID card, reimbursement form and UnionPay card).
Five, the school hospital:
Before each medical year, the medical expenses of the school hospital will be 100 yuan (adjusted in time with the municipal medical insurance policy), and will be reimbursed according to the proportion of 50% (with my ID card), and the students will bear the extra expenses themselves.
Six, matters needing attention:
1. All expenses incurred in private hospitals, clinics, pharmacies and other non-public medical institutions will not be reimbursed.
2. Traffic accidents will not be reimbursed.
3. Cosmetic corrective treatment will not be reimbursed, such as myopia, amblyopia, strabismus, tooth extraction, tooth filling and cosmetic surgery.
4, illegal crime, fighting, alcoholism, drug abuse, self-harm and other medical expenses will not be reimbursed.
5. The Municipal Medical Insurance Office requires that college students try not to hand in medical insurance materials separately. If there are any materials that need to be reimbursed, please give them to the person in charge of medical insurance in our hospital first (the school usually collects them once a month).
The above is Bian Xiao's knowledge about how to reimburse students' medical insurance cards. Students can use medical insurance cards when they go to the hospital after illness, which will reduce some expenses and be very beneficial to students, so we should carefully understand the student medical insurance cards.