How long to go to the medical insurance center after the operati
if you have been discharged, you need to submit the social security card, ID card, medical record, all invoices of hospitalization and operation expenses to the social security center. After leaving the hospital, it will be handed over to the social security department for 45 working days.
"new rural cooperative medical system", full name of new rural cooperative medical system, refers to the mutual medical assistance system for farmers, which is organized, guided and supported by the government, participated by farmers voluntarily, financed by indivials, collectives and the government in many ways, and based on the overall planning of serious diseases
the new rural cooperative medical system is a mutual aid medical security system created by Chinese farmers, which plays an important role in ensuring farmers to obtain basic health services, alleviating poverty caused by illness and returning to poverty e to illness. The reimbursement scope of NCMS includes outpatient compensation, hospitalization compensation and serious illness compensation
the reimbursement scope of the new rural cooperative medical system is as follows:
the part (i.e. effective medical expenses) that the medical expenses, examination expenses, laboratory expenses, operation expenses, treatment expenses, nursing expenses, etc. of the participants who are hospitalized in the designated hospital e to illness ring the overall planning period are in line with the reimbursement scope of medical insurance for urban employees
the new rural cooperative medical fund has set the starting payment standard and the maximum payment limit. The hospitalization expenses below the standard paid by the hospital every year shall be paid by the indivial. For those who reach the minimum payment standard in the same overall planning period, the hospitalization expenses incurred by two or more times of hospitalization can be reimbursed accumulatively. If the hospitalization expenses exceed the starting payment standard, it shall be calculated by sections and reimbursed accumulatively. There is a maximum amount of reimbursement for each person every year<
reimbursement ratio of medical insurance (Taking Chongqing as an example):
1. Outpatient and emergency medical expenses: the part of medical expenses that meet the basic medical insurance regulations in the current year (January 1 to December 31) is more than 2000 yuan
2. Settlement ratio: 50% for the part of dispatched personnel over 2000 yuan ring the contract period, and 50% for indivial payment; In a year, the maximum amount of outpatient and emergency reimbursement for dispatched personnel is 20000 yuan
3. The insured should take good care of the outpatient medical documents (including the receipt of the part below the large amount, the prescription, etc.) as the medical expense reimbursement voucher
4. Outpatient treatment of three kinds of special diseases: when the insured person is suffering from malignant tumor radiotherapy and chemotherapy, renal dialysis, and anti rejection drugs after kidney transplantation, the second and third level designated hospital of the insured person shall issue the "disease diagnosis certificate" and fill in the "application and approval form for special diseases of medical insurance", and report to the district medical insurance center for approval and filing. The outpatient treatment and medication for these three special diseases are limited to the designated hospitals approved for treatment, and cannot be purchased from the designated retail pharmacies. If the medical expenses meet the specified scope of outpatient special diseases, settlement shall be made with reference to hospitalization
5. Hospitalization
after 20 years of medical insurance payment, you can enjoy the medical insurance reimbursement after retirement.
Generally speaking, the medical insurance paid by the unit can be reimbursed in the next month, while the medical insurance paid by the indivial identity generally needs to pay more than half a year or more to enjoy the reimbursement treatment
when going through the hospitalization proceres, the medical insurance records and medical insurance card should be handed over to the inpatient department of the hospital, so that the medical insurance co-ordination account can be used smoothly. If the medical insurance records and medical insurance card cannot be submitted at that time e to the emergency, they should be handed over to the hospital in time. In general, if there is a starting line for medical insurance reimbursement, different starting lines should be set up according to different levels of hospitals. The higher the level, the higher the starting line. It is 100 yuan for the first-class and below hospitals in the city, 200 yuan for the second-class hospitals in the city, 300 yuan for the third-class hospitals in the city and 400 yuan for the non municipal hospitals. If the starting line is not reached, the reimbursement will not be supported. In other words, it must be above the starting line before reimbursement can be made. The part above the starting line shall be reimbursed according to the regulations. In addition, there may be some drugs that are not within the scope of medical insurance and need to be borne by themselves), so they need to pay part of the cash when they go through the hospitalization proceres
the reimbursement of medical insurance is carried out in proportion. In different levels of hospitals, the reimbursement proportion is different. Generally around 70%. The proportion and amount of reimbursement are related to their own examination and medication, medical grade and other factors. For example, it is clear that class a drugs can be fully reported, while class C drugs need to pay for all the expenses, while class B drugs need to pay 80% of the expenses and 20% of the expenses
for example, the starting line of hospitalization is 1000 yuan, and the self paid medicine is 500 yuan. If someone's medical expenses total 5000 yuan. 85% for reimbursement and 15% for self payment
then the medical insurance can be reimbursed = (5000-1000-500) x85% = 3500x85% = 2975 yuan, which is not paid, and the hospital will directly settle accounts with the medical insurance bureau
in addition, indivials need to pay cash = 1000 + 500 + (5000-1000-500) x15% = 1500 + 525 = 2025 yuan, which is in cash
if you pay in advance (even if you borrow some money first), you will get a small part of the operation expenses by yourself, which will be returned to you when you leave the hospital and go through the discharge proceres!! Let you pay the actual deposit of the operation cost, the hospital is afraid that you put people, it doesn't matter, actually you don't have to spend much money
my sister had an operation two days ago! General anesthesia + total mastectomy is not more than 5000 reimbursement + inpatient drugs + Inspection = more than 7000!! But it only costs more than 1400 yuan to settle the bill after discharge!! Not much! So you don't have to worry!! The money will be returned to you!
Medical insurance reimbursement:
(1) reimbursement scope: the hospitalization expenses of the insured in the designated hospital or specialized hospital, traditional Chinese medicine hospital and class a hospital selected by the indivial
(2) reimbursement ratio: in a natural year, the starting payment standard for the first hospitalization is 1300 yuan, and then 650 yuan each time. The proportion of payment is divided into three levels. Take the tertiary hospital as an example, the fluctuation standard is: 30000 yuan, 85% in service, 91% retired, 30000-40000 yuan, 90% in service, 94% retired, more than 40000 yuan, 95% in service, 97% retired. 90 days of general hospitalization is a settlement cycle. 360 days of psychiatric hospitalization is a settlement cycle, and the fluctuation standard is halved. In a natural year, the fund can pay up to 70000 yuan. The maximum amount of hospitalization payment is 100000 yuan, and the proportion of hospitalization payment is 70%< (3) medical treatment management: if the unit pays in full, the indivial only needs to pay part of the hospitalization prepayment to go through the hospitalization proceres. The medical expenses should be in line with the scope of the three catalog databases of medical insurance
(4) reimbursement process: when discharged, the hospital and the indivial settle the part of the amount at their own expense and at their own expense, and the reimbursement amount of the co-ordination fund is settled by the hospital and the district medical insurance center
The recovery time of medical insurance varies from place to place. In most places, the recovery standard of three months is implemented. In some places with good welfare, it is one to two months. You'd better consult the local social security directly, and their reply shall prevail. I don't know if your operation will take that long
How to buy insurance, which is better, hand in hand to teach you to avoid these "pits" of insurance1. How much medical insurance can be reimbursed for the expenses of examination and operation in a tertiary hospital depends on the relevant regulations of the local social security fund Bureau. It is suggested to consult the local 12333
How to buy insurance, which is better, hand in hand to teach you to avoid these "pits" of insurance1、 The reimbursement process of medical insurance is as follows:
the insured should pay the deposit for hospitalization first with their ID card and doctor's admission arrangement
when discharged from hospital, go to the hospital charge office to settle the discharge expenses, and submit the hospitalization documents, charge documents, insured medical insurance cards and ID cards to the affiliated medical institutions for reimbursement
Second, medical insurance reimbursement materials:1, medical insurance card
2, outpatient and emergency medical record book
3, prescription
4, total expense list
5, discharge diagnosis certificate
6, discharge summary
7, of hospitalization medical record
8, invoice
3, personal medical insurance account is established according to basic medical insurance policy It is a special account specially used for storing the medical insurance premium paid by the insured and the funds transferred in a certain proportion from the payment of the employer, and recording the medical consumption
The fund of personal account is used to pay for the expenses of medical treatment and out of pocket purchase of medicine 
extended data:
reimbursement of medical insurance:
I. outpatient compensation:
1. Reimbursement of 60% in village clinics and village center clinics. The limit of prescription drug fee for each visit is 10 yuan, and the limit of prescription drug fee for temporary rehydration of doctors in health center is 50 yuan
2 The reimbursement rate of the township health center is 40%, the limit of each examination and operation fee is 50 yuan, the limit of prescription drug fee is 100 yuan
3, the reimbursement rate of secondary hospital is 30%, the limit of each examination and operation fee is 50 yuan, the limit of prescription drug fee is 200 yuan
4, the reimbursement rate of tertiary hospital is 20%, the limit of each examination and operation fee is 50 yuan, The limit of prescription drug cost is 200 yuan
5. The limit of each paste of prescription is 1 yuan with the invoice of traditional Chinese medicine
6. The annual compensation limit of Township cooperative medical outpatient service is 5000 yuan
2. The reimbursement scope of hospitalization compensation is
1. Drug cost: auxiliary examination: cardio encephalogram, X-ray fluoros, film making, chemical examination, physiotherapy, acupuncture, CT, MRI and other examination expenses are 200 yuan, operation expenses
2 The elderly over 60 years old are hospitalized in Xingta town health center, and the compensation for treatment and nursing expenses is 10 yuan per day, with a limit of 200 yuan.
3. Reimbursement proportion:
① reimbursement rate of town health center is 60%
② reimbursement rate of secondary hospital is 40%
③ reimbursement rate of tertiary hospital is 30%
(3) compensation for serious illness (1) compensation of town risk fund: for inpatients who have participated in rural cooperative medical insurance, the one-time or annual accumulative medical expenses should be more than 5000 yuan, namely, 65% of 5001-10000 yuan and 70% of 10001-18000 yuan2. The annual compensation limit of hospitalization and uremia outpatient hemodialysis, tumor outpatient radiotherapy and chemotherapy in Township cooperative medical system is 11000 yuan
(4) not covered by the reimbursement scope of rural cooperative medical insurance:1. Self medical treatment, self purchased drugs, non reimbursable drugs according to public medical regulations and medical expenses not in line with family planning
2. Outpatient treatment expenses, visiting expenses, hospitalization expenses, board expenses, accompanying expenses, operation and maintenance expenses, blood transfusion expenses, heating and cooling expenses, ambulance expenses, special care expenses and other expenses
3 Medical expenses of traffic accident, fight, suicide, alcoholism, instrial accidents and medical accidents
4. Orthopedics, plastic surgery, dental inlay, prosthetic limbs, organ transplantation, name calling operation, consultation, etc.