Is there a time limit for Medicare reimbursement?

There is no time limit for the use of the health insurance card, but there is a limit to the number of times.

When the number of medical insurance card transactions reaches 60, the insured employee must go to the Bank of China Savings Bank to print the transaction records, otherwise, the use of the card will be stopped. Once the transaction history is printed, the card can continue to be used.

In the pharmacy 100% of their own responsibility, hospitalization can enjoy the reimbursement ratio (it must also be covered by medical insurance). If the hospitalization is within the scope of medical insurance, according to the actual amount of expenses, for example, the reimbursement range of 10,000 yuan is between 55% and 65%.

1. There is a limit on the time for medical insurance reimbursement after discharge, and the insured must go through the medical insurance reimbursement procedures within the specified time.

1. If the medical insurance insured person is hospitalized in a designated network hospital, he or she can directly settle the medical expenses on the spot when he is discharged. However, due to special circumstances, such as the insured person seeking medical treatment in a medical institution in another province or city, the insured person must pay the medical expenses first, and then go to the social insurance institution in the place where the insured person goes through the medical expense reimbursement procedures. In this case, there is a time limit for medical insurance reimbursement when you are discharged from the hospital.

2. Time limit for reimbursement of medical insurance in other places:

At present, China has not fully realized the national network of medical insurance, so the insured person must pay the medical expenses first, and then bring the ID card, social security card, hospitalization expense list and other information to the social security institution to go through the hospitalization expense reimbursement procedures.

In order to ensure the safety of medical insurance, various regions in China have limited the reimbursement time of medical insurance in different places. The reimbursement time period varies depending on the actual situation in different places, but the basic period is 6 months to 1 year.

According to China's current medical insurance policy, it is generally not reimbursed if the medical insurance reimbursement time is exceeded. Generally, the medical expenses are reimbursed in the current year, not in alternate years.

If you are hospitalized on a multi-year basis, you must also settle and reimburse the medical expenses of the current year, and you cannot be reimbursed after expiration, so it is hoped that the insured can apply for reimbursement to the local medical insurance agency in time after incurring relevant expenses. For more information, please call your local Social Security Administration**12333.

There is no time limit, but it is generally reimbursed directly at the time of discharge from the hospital. Medical insurance refers to the basic medical insurance premiums that should be paid in full and on time by the employer and the individual employee in accordance with the principle of compulsory social insurance through national legislation. If you do not pay in full and on time, regardless of your personal account, the basic medical insurance coordinator will not pay your medical expenses.

Legal analysis: There is no time limit, but it is generally reimbursed directly at the time of discharge from the hospital. Medical insurance refers to the basic medical insurance premiums that should be paid in full and on time by the employer and the individual employee in accordance with the principle of compulsory social insurance through national legislation.

If you do not pay in full and on time, regardless of your personal account, the basic medical insurance coordinator will not pay your medical expenses. Reimbursement ratio, outpatient and emergency medical expenses: the part of the medical expenses that meet the scope of basic medical insurance within the year (January 1 to December 31) of in-service employees exceeds 2,000 yuan.

Settlement ratio: 50% of the part of the dispatched personnel more than 2,000 yuan during the contract period, and 50% of the personal payment; The maximum amount of reimbursement for outpatient and emergency treatment of dispatched personnel in a year is 20,000 yuan. Medical insurance refers to the basic medical insurance premiums that should be paid in full and on time by the employer and the individual employee in accordance with the principle of compulsory social insurance through national legislation.

If you do not pay in full and on time, regardless of your personal account, the basic medical insurance coordinator will not pay your medical expenses. The following information should be brought when reimbursing: 1. Original ID card or social security card; 2. The original certificate of disease diagnosis issued by the specialist doctor of the designated medical institution; 3. Original medical information such as outpatient medical records, examinations, and test result reports; 4. The original receipt of outpatient charges of the unified financial and taxation medical institutions; 5. The detailed list of outpatient expenses printed by the hospital computer or the original payment prescription issued by the doctor; 6. Designated pharmacies:

The original uniform invoice for the sale of tax commodities and the computer-printed list; 7. If it is handled on behalf of the agent, the original ID card of the agent needs to be provided. Bring all the above information to the relevant departments of the local social security center to apply for processing, and after review, the information is complete and meets the requirements, you can handle it immediately. When the applicant applies for reimbursement of outpatient medical expenses, the amount transferred to the personal account of medical insurance in the current social security year shall be deducted first, and then the reimbursement amount shall be approved.

Legal basis: Article 8 of the Detailed Rules for the Implementation of the Social Insurance Law stipulates that the medical expenses incurred by the insured persons in the agreed medical institutions shall be paid from the basic medical insurance in accordance with the provisions of the state. If the insured person really needs emergency treatment or rescue, he or she can seek medical treatment in a non-agreed medical institution; The scope of drugs that must be used for rescue purposes may be appropriately relaxed.

The specific management measures for medical services for emergency and rescue of insured persons shall be formulated by the overall planning area according to the actual local situation.

Normally, the reimbursement time frame is generally no more than one year, but in some regions it is two years. If you want to know the exact information, you can consult your local social security office.

Reimbursement procedures for basic medical insurance for urban residents:

1.After the insured patient is discharged from the hospital, he or she must submit the following items before the 1st of each month

A copy of the first page of the medical record (stamped by the medical insurance department of the hospital).

Discharge summary. Receipts for hospitalization expenses.

Breakdown of inpatient medical expenses (one-day list).

A copy of the medical insurance cash payment slip.

Discharge certificate. A copy of the ID card is handed over to the community for relevant registration.

2.Before the 5th of each month, each community will report the relevant materials and forms to the district medical insurance office.

3.From the 5th to the 10th of each month, the District Medical Insurance Office reviews the relevant bills and calculates the reimbursement amount.

4.From the 12th to the 15th of each month, it will be reported to the Municipal Medical Insurance Center for approval.

5.At the beginning of the following month, the reimbursement fee is paid. Insured patients need to bring their ID cards to the district medical insurance office to collect.

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[Legal Analysis].: There is a time limit for medical insurance reimbursement, which is generally limited to one year. That is to say, within one year after discharge, it is okay to go to the designated institution to reimburse the medical insurance expenses, and once it has not been reimbursed for more than one year, it can no longer be reimbursed.

Moreover, according to the regulations, the medical expenses of the current year are to be reimbursed in the current year, and reimbursement in alternate years is not allowed.

[Legal basis].Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers

Article 7 The basic medical insurance premiums shall be paid jointly by the employer and the employee. Among them, the employer shall pay 5-7 of the total monthly salary of the employee, and the rate of basic medical insurance premium paid by the employee shall not be less than 2 of the total monthly salary of the employee.

Article 8 The amount of monthly wages paid by employees shall be determined according to their actual total wages, but shall not be less than 60 percent of the average monthly wages of employees in the previous year in the city, county, or autonomous county where they are located.

Article 9 The part of the employee's total monthly salary that exceeds the average monthly social wage of the employee in the city, county, or autonomous county of the previous year by more than 300 yuan shall not be paid for basic medical insurance, nor shall it be used as the basis for approving the quota of the personal account.

Article 10 Within 30 days after obtaining a business license or being approved for establishment, an employer must go to the social insurance agency to register for basic medical insurance. When there is a change in the registration items or the obligation to pay is terminated in accordance with law, the modification or cancellation of registration shall be handled in a timely manner. The social insurance agency shall promptly notify the collection authority of the registration situation.

The employer shall, within 10 days after completing the registration procedures for basic medical insurance, register with the collection authority for the payment of basic medical insurance premiums in accordance with the relevant regulations.

The above is only the current information combined with my understanding of the law, please refer to it carefully!

If you still have questions about this issue, it is recommended that you organize the relevant information and communicate with a professional in detail.

Summary. Medicare reimbursement is time-limited. The time limit for Medicare reimbursement is divided into two main parts:

Outpatient reimbursement and inpatient reimbursement. For outpatient reimbursement, the medical insurance stipulates that patients need to go to the designated medical institutions for reimbursement within 30 days after treatment, and cannot be reimbursed for more than 30 days. In addition, there are some other restrictions on outpatient reimbursement, such as the need to provide valid outpatient bills, medical expense details, etc.

For hospitalization reimbursement, the medical insurance stipulates that reimbursement should be made at the designated medical institution within 90 days after discharge, and it cannot be reimbursed after 90 days. In addition, hospitalization reimbursement also needs to provide hospitalization expensesIt should be noted that there may be some differences in medical insurance policies in different regions, which are subject to local medical insurance policies.

Medicare reimbursement is time-limited. The time limit for Medicare reimbursement is mainly divided into two parts: outpatient reimbursement and inpatient reimbursement.

For outpatient reimbursement, the medical insurance stipulates that patients need to go to the designated medical institutions of Wusheng for reimbursement within 30 days after treatment, and cannot be reimbursed for more than 30 days. In addition, there are some other restrictions on outpatient reimbursement, such as the need to provide valid outpatient bills, medical expense details, etc. For hospitalization reimbursement, the medical insurance stipulates that reimbursement should be made at the designated medical institution within 90 days after discharge, and the rent cannot be reimbursed for more than 90 days.

In addition, hospitalization reimbursement also needs to provide hospitalization expenses need to be injected into the cavity The old thing is that there may be some differences in the medical insurance policies in different regions, which are subject to the local medical insurance policies.

In addition to time constraints, there are some other restrictions on Medicare reimbursement. For example, medical insurance can only reimburse medical expenses that meet the regulations, and if a patient chooses a non-medical insurance designated medical institution or a non-medical insurance payment item during a banquet, this part of the expenses cannot be reimbursed. In addition, the medical insurance also stipulates the reimbursement ratio and maximum reimbursement limit for each medical item, and patients need to choose and pay according to the medical insurance regulations.

There is a time limit for medical reimbursement, but the time limit for reimbursement varies from city to city.

For example, the current "Shenzhen Medical Insurance Policy" stipulates that if the insured pays the medical expenses in advance, he or she shall apply for reimbursement within 12 months from the date of occurrence or discharge of the expenses, and will not be reimbursed after the deadline. Another example is the Measures for the Settlement of Basic Medical Insurance for Urban and Rural Residents in Shanghai, which stipulates that sporadic reimbursement for insured persons shall be applied for within 3 months from the date of receipt issued by the medical institution.

There is a time limit.

1: The reimbursement time limit of basic medical insurance is generally the current year, and it should be reimbursed in the current year.

2: The reimbursement time limit for commercial medical insurance is two to five years to apply for validity (the insurance contract has not been terminated), the statute of limitations for death insurance claims is five years, and the statute of limitations for medical expenses insurance claims is two years, even in other places.

The time limit for medical insurance reimbursement is generally one year. If this period is exceeded, it will be more difficult to reimburse medical insurance, and even if it can be reimbursed, the scope of reimbursement is limited. Therefore, as long as it is reimbursed within one year after discharge, it is okay, and once this period has passed, the policy must be renewed.

Article 25 of the Social Insurance Law.

The State shall establish and improve a basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy.

Those who enjoy the minimum living guarantee, disabled distributors who have lost the ability to work, the elderly over the age of 60 and minors from low-income families, etc., will be subsidized by **.

Article 29.

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses for medical treatment in other places to facilitate the insured to enjoy basic medical insurance treatment.

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