How to reimburse Beijing medical insurance
As medical expenses continue to rise, medical insurance reimbursement has become the focus of public attention. Recently, Beijing’s medical insurance reimbursement policy has once again become a hot topic. This article will introduce in detail the reimbursement process, reimbursement ratio, required materials, etc. of Beijing Medical Insurance to help you better understand and use medical insurance.
1. Beijing medical insurance reimbursement process
Beijing medical insurance reimbursement is mainly divided into two methods:Real-time settlementandManual reimbursement.
| Reimbursement method | Applicable situations | Operation steps |
|---|---|---|
| Real-time settlement | Seeking treatment at designated medical institutions | 1. Seek medical treatment with social security card 2. The medical insurance reimbursement portion will be automatically deducted during settlement. 3. Only pay the personal out-of-pocket portion |
| Manual reimbursement | Seeking medical treatment in other places or settling the bill without holding a card | 1. Save medical expense receipts 2. Fill out the reimbursement application form 3. Submit to the medical insurance agency 4. Waiting for approval of funding |
2. Beijing medical insurance reimbursement ratio
The reimbursement ratio of Beijing’s medical insurance varies according to the level of the hospital and the type of insurance, as follows:
| hospital level | Current employees | retirees |
|---|---|---|
| First class hospital | 90% | 95% |
| Secondary hospital | 87% | 92% |
| Tertiary hospital | 85% | 90% |
3. Materials required for Beijing medical insurance reimbursement
When reimbursing manually, you need to prepare the following materials:
| Material name | Remarks |
|---|---|
| social security card | Original and copy |
| Medical bill | Original |
| detailed list of expenses | Issued by the hospital |
| Diagnosis certificate | Stamped with the official seal of the hospital |
| Reimbursement application form | Receive from medical insurance agency |
4. Things to note when reimbursing medical insurance in Beijing
1.Designated medical institutions: Reimbursement requires treatment at a medical insurance designated medical institution. Expenses from non-designated institutions will not be reimbursed.
2.Reimbursement time limit: Manual reimbursement must be processed within one year after the expense is incurred. Overdue reimbursement will not be accepted.
3.Minimum payment standard: Beijing’s medical insurance has a deductible payment line, which is 1,800 yuan for outpatient services and 1,300 yuan for hospitalization.
4.Drug catalog: Only drugs included in the medical insurance catalog can be reimbursed, and self-paid drugs must be paid in full by individuals.
5. Recent hot issues
1.Reimbursement for out-of-town medical treatment: With the advancement of the integration of Beijing, Tianjin and Hebei, the reimbursement process for medical treatment in other places has been simplified, but advance filing is still required.
2.Internet hospital reimbursement: Some Internet hospital medical expenses have been included in the scope of medical insurance reimbursement, but attention must be paid to the hospital qualifications.
3.Medical insurance personal account reform: The recent adjustment of the fund transfer method for Beijing Medical Insurance personal accounts has triggered widespread discussion.
6. Summary
Beijing’s medical insurance reimbursement policy has been continuously improved, providing strong medical protection for the general public. Understanding the reimbursement process and precautions can help you use medical insurance more efficiently and reduce your medical burden. It is recommended to pay attention to medical insurance policy updates regularly and keep abreast of the latest changes.
If you need further consultation, you can call the Beijing medical insurance service hotline 12333, or go to the medical insurance agency in each district for on-site consultation.
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