The insured should go to the designated medical institution for medical treatment. When leaving the hospital with a medical insurance card (ID card or household register is allowed if the medical insurance card is not available for the time being), the medical expenses for hospitalization can be directly settled at the settlement window of the designated hospital.
Medical insurance reimbursement conditions for Changsha employees
1. The applicant has gone through insurance procedures and paid medical insurance premiums in full; 2. The cooperative medical service designated medical institutions for medical treatment; 3. The insured has incurred hospitalization medical expenses in the medical institution on record, paid cash in advance, and kept relevant documents and materials.
Reimbursement standard of medical insurance for employees in Changsha
In a settlement year, the maximum payment limit of medical insurance for urban employees in Changsha City is 300000 yuan, of which the maximum payment limit of basic medical insurance pooling fund is 120000 yuan, the maximum payment limit of serious illness medical mutual aid fund is 180000 yuan, and the payment section is from the part above the maximum payment limit of basic medical insurance pooling fund to 300000 yuan.
The minimum payment standard for hospitalization of insured employees is: 900 yuan for first-class medical institutions; Class II charging standard medical institutions 650; Class III charging standard medical institutions (including township health centers and community health service institutions) are 480 yuan.
If the insured person is hospitalized for many times in a settlement year, the primary and secondary reimbursement standards will be reduced. The second hospitalization will be calculated as 50% of the prescribed reimbursement standards, and the third hospitalization and above will be calculated as 30% of the prescribed reimbursement standards.
