Where to report the second reimbursement of medical insurance, and where to go to the second reimbur

The second reimbursement of medical insurance can be handled at the hospital where you seek medical treatment, and you can swipe your social security card directly at the hospital, and it will be automatically settled when the second reimbursement amount is reached.

Extended Content:

Relevant policies for secondary reimbursement in Jinan

1. When does Jinan employee insured start to enjoy the second reimbursement policy?

Since January 1, 2018, Jinan Employee Medical Insurance has launched a secondary reimbursement policy.

2. Under what circumstances can I use secondary reimbursement?

After the hospitalization and door regulation expenses incurred by the employee medical insurance insured in a medical year are reimbursed by the medical insurance according to the regulations, the part of the eligible medical expenses borne by the individual in excess of 10,002 can enjoy the second reimbursement.

How much can be reimbursed by the 32nd reimbursement policy?

In a medical year, 60% of the eligible medical expenses borne by the individual employee shall be reimbursed for the part of the excess of more than 10,000 yuan and less than 200,000 yuan; 70% of the part above 200,000 yuan and less than 400,000 yuan will be reimbursed; The part below 10,000 and more than 400,000 will not be reimbursed.

4. Can the expenses of hospitalization in other places enjoy the policy of secondary reimbursement?

The secondary reimbursement policy is open to all employee medical insurance participants, and in the hospitalization and door regulation expenses, as long as the cumulative compliant medical expenses borne by the individual after reimbursement by the medical insurance are greater than 10,002, they can enjoy the second reimbursement, regardless of whether the expenses occur in other places or localities.

If the non-local hospitalization expenses are self-paid and then apply for cash reimbursement, the medical insurance reimbursement amount and the secondary reimbursement amount will be calculated and issued together.

If the non-local hospitalization expenses are directly reimbursed through online settlement, the amount of the second reimbursement will be automatically accumulated and distributed by the system after the end of the year, without any application procedures.

5. What are the procedures for handling the second reimbursement?

There is no application procedure for the second reimbursement, and if you meet the conditions, you can enjoy it in the normal settlement of the hospital. The reimbursement of Jinan employee medical insurance is composed of two parts: medical insurance pooling fund and large relief fund, and now a second reimbursement has been added, the purpose is to reduce the burden of medical treatment for the insured.

Is there a restriction on the number of diseases reimbursed for the 62th reimbursement?

The second reimbursement is not limited to the type of disease. As long as the cumulative amount of burden meets the conditions, you can enjoy the policy.

7. Supporting policies

In order to reduce the medical burden of the insured, in addition to the secondary reimbursement policy this year, the first cost of heart, liver and lung transplantation for employee medical insurance has also been included in the reimbursement scope of hospitalization medical insurance. At the same time, organ donors can also enjoy medical insurance reimbursement.

Generally speaking, after the first reimbursement, the insured's out-of-pocket payment includes three parts: the hospital threshold fee (different levels of hospitals) + the unfinished part within the scope of medical insurance reimbursement + outside the scope of medical insurance reimbursement (that is, those that cannot be reimbursed). The "second reimbursement of medical insurance" is the second reimbursement of the part of the insured that has not been reimbursed within the scope of medical insurance reimbursement after the first reimbursement, and this part of the cost can only be reimbursed if it exceeds 600 yuan.

Hospitalization Second Medical Insurance" Introduction:

Coverage: Hospitalization due to illness** (including emergency observation and hospitalization**), outpatient specific items and outpatient chronic diseases**, death or disability due to accidents and burns.

Participation conditions: 16 60-year-old employees (including party and government organs and institutions with publicly-funded medical care) within the scope of basic medical insurance for urban employees can participate.

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or the NCMS medical certificate for hospitalization registration, and when discharged, bring the relevant materials to the serious illness settlement window to directly reimburse the serious illness expenses with the medical insurance card.

2.The settlement department of the medical insurance agency:

For out-of-town medical treatment.

After being discharged from the hospital, bring the original voucher for medical expenses.

Certificates such as expense lists, medical certificates, and discharge summaries can be applied for a second reimbursement at the local medical insurance agency.

Extended information] Medical insurance generally refers to basic medical insurance.

It is a social insurance established to compensate workers for economic losses caused by the risk of illness.

System. Through the employer and individual payment, the establishment of medical insurance**, after the insured person is sick and incurs medical expenses, the medical insurance institution will give him a certain amount of economic compensation.

The establishment and implementation of the basic medical insurance system gathers the economic strength of the unit and the members of the society, coupled with the first funding, which can enable the sick members of the society to obtain the necessary material help from the society, reduce the burden of medical expenses, and prevent the sick members of the society from "becoming poor due to illness".

In November 2019, the first batch of 422 diseases and payment methods in Anhui were announced, and from January 1, 2020, medical insurance for urban and rural residents.

When the insured people seek medical treatment in the 18 provincial hospitals, there will be a unified payment standard.

Origin and development: Medical insurance, in the traditional sense, refers to the management of a specific organization or institution, through the enforcement of the belt.

Policies and regulations or voluntary contracts to raise medical insurance among a certain number of insured people in a certain area**.

Medicare originated in Western Europe and can be traced back to the Middle Ages. With the success of the bourgeois revolution, the cottage workshop was replaced by big industry, and the modern industrial contingent appeared. Due to the harsh working environment, the occurrence of epidemic diseases and industrial accidents makes workers demand appropriate medical attention.

However, their wages are low, making it difficult for individuals to pay for medical expenses. As a result, workers in many places organized themselves to raise a part of the money to cover expenses in case of illness. But this form is not very stable, and it is small-scale, and the ability to resist risks is very low.

At the end of the 18th century and the beginning of the 19th century, private insurance developed in Western Europe and became an important way for the state to raise medical funds.

Medical insurance has the basic characteristics of social insurance, such as compulsory, mutual aid and sociality. Therefore, the medical insurance system is usually enforced by national legislation, and the establishment of a first-class system, the cost is jointly paid by the employer and the individual, and the medical insurance premium is paid by the medical insurance institution to solve the medical risk caused by the illness or injury of the worker.

The second reimbursement is limited to NCMS, and reimbursement can be made at the hospital window or the NCMS Settlement Department.

The NCMS secondary reimbursement process is based on the immediate settlement of NCMS insured persons who seek medical treatment in local second-class hospitals or designated hospitals due to serious illness, and can directly pay the critical illness insurance compensation funds in advance by the hospital at the hospital charging window, and will be automatically reimbursed according to the proportion of NCMS serious illness insurance when discharged, without additional reimbursement procedures.

Materials required for the second reimbursement of NCMS, NCMS compensation settlement form; The original household registration and participation card (card) of the resident ID card patient; Invoice for medical institution expenses, or a copy of the official seal of the original receiving and depositing unit; The list of expenses, the discharge statement or the official seal of the original collection unit.

Legal basis: Article 31 of the Social Insurance Law of the People's Republic of China Social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and drug business units to standardize medical services.

Medical institutions shall provide reasonable and necessary medical services to insured persons.

The second reimbursement of medical insurance shall be handled at the Social Security Bureau. 1. You need to fill in the application form according to the process, and prepare the hospitalization records, outpatient medical records, relevant medical documents and inspection reports during the illness period. Of course, you must also prepare your own identification and a one-inch **.

2. Submit the materials to the Social Security Bureau and other relevant units after they are ready, and then submit them to the Medical Insurance Center for approval after the unit is stamped with the official seal. In the approval process, if it is due to one's own illness, it can also be handled by family members. 3. After being approved by the medical insurance center, if there is no problem, the serious illness subsidy will be issued according to national regulations.

When receiving the second subsidy, please bring the original and photocopy of the second-generation resident ID card of the person enjoying the second subsidy, and the bank card or passbook of the city (except for the Rural Commercial Bank); If you do not come to handle it in person, you also need to provide the original and copy of the agent's second-generation resident ID card and go to the Municipal Social Security Center for processing.

"Second reimbursement" means that residents of urban residents' medical insurance or NCMS can apply for serious illness insurance again in addition to normal reimbursement if they have high expenses for medical treatment last year, and there is no upper limit.

The second reimbursement of medical insurance refers to the reimbursement of basic medical insurance, and the part of the amount that needs to be paid by the individual will be re-reported by the retirees and military disability subsidies according to the corresponding proportion. In fact, it is the reimbursement of supplementary medical insurance. That is, the hospitalization expenses (including family beds and out-of-town medical treatment) that have been settled within one year, and the part of the self-payment minus the part of category C expenses accumulated throughout the year is more than 10,000 yuan, can enjoy the second subsidy of medical insurance**.

Medical Insurance Secondary Reimbursement Process:

1. Reimbursement of outpatient and emergency expenses.

The minimum payment amount for large-amount medical mutual aid (outpatient and emergency) is 2,000 yuan for in-service employees and 1,300 yuan for retirees. If the accumulated outpatient and emergency expenses within a year are less than 2,000 yuan for employees and less than 1,300 yuan for retirees, they shall be paid by the insured from their personal accounts. If the amount above the threshold is reached within a calendar year, the large amount of mutual medical assistance can be applied.

2. Reimbursement of hospitalization expenses.

According to the regulations, when the basic medical insurance is used to pay for hospitalization expenses for the first time in a year, the minimum payment amount for incumbents and retirees is 1,300 yuan. For the second and subsequent hospitalizations, the minimum payment standard is determined at 50% and is 650 yuan. The maximum payment of basic medical insurance pooling** (hospitalization expenses) in a year is currently 70,000 yuan.

The individual payment rate for retirees is 60% of the individual payment rate for active employees, but the part below the threshold is the same, and all payments are made by individuals. The standard of reimbursement for hospitalization is related to the level of the medical institution where the insured person lives.

Note: Outpatient and inpatient are two minimum payment lines.

3. How much does it cost to pay more than the maximum payment limit?

If the hospitalization expenses of the insured person exceed the maximum payment limit, the excess expenses will be reimbursed according to the relevant standards of large-amount mutual medical assistance, that is, 70% will be paid by the large-amount mutual medical assistance fund and 30% will be paid by the individual. Within one year, the cumulative maximum amount of payment for large-scale mutual medical assistance is 100,000 yuan.

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Hello, the second reimbursement of medical insurance goes to the local social security bureau for the second reimbursement of medical insurance. 1. The reimbursement process is as follows: 1. The applicant should bring his ID card and medical insurance card to the designated medical institution for reimbursement procedures.

If the insured person entrusts others to handle it, he or she shall also provide the original and copy of the second-generation resident ID card of the first person. 2. Submit relevant materials. 3. Conduct an audit.

4. After the audit is passed, the insured brother Xun can get the second reimbursement of medical insurance. 2. Materials required for reimbursement: ID card, medical insurance compensation statement, medical institution expense invoice, discharge summary, diagnosis certificate, outpatient medical record, bank remittance account number, etc.

3. The second reimbursement of medical insurance is also called critical illness insurance underwriting, which refers to the residents who participate in the urban residents' medical insurance or the New Rural Cooperative Medical System, if the medical expenses exceed their personal affordability, in addition to the normal reimbursement, they can also apply for a serious illness insurance reimbursement, and there is no upper limit. [Legal basis] Article 28 of the Social Insurance Law of the People's Republic of China, in line with the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, in accordance with national regulations from the basic medical insurance **.

Hello dear is happy to serve you, thank you for your patience. The second reimbursement of medical insurance shall be handled at the local social security bureau. ID card and photocopy, NCMS medical certificate and photocopy, NCMS discharge compensation form, bank card, doctor's certificate, hospitalization summary, hospitalization receipt, medical details, patient's ID card, first reimbursement voucher.

The reimbursement process of the new agricultural inspection dismantling: 1. Information required for reimbursement: information for outpatient reimbursement:

Outpatient invoices, cooperative medical certificates (or medical records). Hospitalization reimbursement materials: hospitalization invoices, cooperative medical certificates (or medical records), detailed list of expenses, discharge summary, and other relevant certificates.

2. Outpatient special disease reimbursement materials: outpatient invoices, special disease cooperative medical certificates. Which to handle the special defeat of the jujube disease to carry the information:

Proposal for outpatient clinic for special diseases, cooperative medical certificate calendar, medical record, relevant laboratory report, **2.

Many people don't know that medical insurance can be reimbursed twice, how can they enjoy the second reimbursement of medical insurance? First, it must be enrolled in the medical insurance for urban and rural residents, or the rural new rural cooperative medical insurance, and purchased separately.

Second: If the annual expenses exceed the specified amount, you can enjoy a second reimbursement. Third:

When applying for a second reimbursement, you need to bring the case book, the voucher of the first reimbursement, and the discharge certificate.

When applying for the second reimbursement, you need to bring the following materials to go through the relevant procedures: 1. NCMS compensation settlement form; 2. The original household registration and participation card (card) of the resident ID card patient; 3. Invoice for medical institution expenses, or a copy of the official seal of the original collection unit. Hope it helps!

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