1, in the designated hospitals in the city, choose the municipal and township hospitals in the city. When you are in hospital, you should carry your personal information card and ID card of the cooperative medical system with you, and take the initiative to show it when you go through the admission formalities.
2. If you need to be transferred to a designated hospital outside the city for hospitalization due to illness, you should first apply for a referral certificate in a municipal hospital in this city, and then apply for a referral letter to the Municipal Medical Office.
3. If the participating farmers really need to be hospitalized in non-designated hospitals outside the city, they should be approved by the Municipal Medical Management Office first, otherwise their medical expenses will not be reimbursed.
4. If a farmer is hospitalized in a foreign non-profit hospital due to illness during his absence, his family members should report to the Municipal Medical Insurance Office within 7 working days after hospitalization, and go through the relevant registration formalities at the Municipal Medical Insurance Office within 30 days with the emergency hospitalization certificate, ID card and personal information card of cooperative medical care, otherwise his medical expenses will not be reimbursed.
(a) take the initiative to show the cooperative medical personal information card and identity card when going through the admission formalities in the intranet hospital of the city, and can directly reimburse the medical expenses at the time of discharge settlement.
(2) Being hospitalized in a hospital in this city or a hospital outside the city.
1. Time and place of reimbursement Participating farmers can go to the township (street) medical management office for reimbursement every Monday; Those in urgent need of funds can also go directly to the Municipal Medical Adjustment Office (No.259 Shengzhou Avenue, 3 107 128) for reimbursement every Monday to Friday.
2. Information required for reimbursement ① Personal information card of cooperative medical care; (2) ID cards of patients and reimbursers; ③ Invoice of hospitalization medical expenses; (4) summary of expenses; (5) outpatient medical records or discharge summary.
Transfer to designated hospitals outside the city, need to provide a referral receipt; If you are hospitalized in a foreign non-profit hospital during your trip, you need to provide a certificate issued by the patient's village.
3. Reimbursement standard considers the effective hospitalization medical expenses of farmers in the settlement year (referring to the medical expenses that meet the scope of payment), and adopts the reimbursement method of "subsection calculation and cumulative payment": ① The qifubiaozhun for hospitalization in designated township (street) hospitals and health centers in the city is 500 yuan, and the qifubiaozhun for hospitalization in medical institutions inside and outside the city is 1 000 yuan. Those below Qifubiaozhun will not be reimbursed; (2) 1000 yuan to 5000 yuan (including 5000 yuan, the same below) 20%; (3) 30% of 5000 yuan to 10000 yuan; (4) 1 40% of ten thousand yuan; ⑤ The cumulative maximum reimbursement limit per person per year is 12000 yuan.
Hospitalization in designated hospitals outside the city and non-designated hospitals outside the city will be converted into reimbursement base according to the proportion of 80% and 70% of the medical expenses that meet the prescribed reimbursement scope with the approval of the Municipal Medical Office.