Parents do not understand the policy, children's medical insurance is not ideal for social welfare
Seeing ordinary clinics can also be reimbursed, is the voice of the people for medical insurance for children.
On September 1st, after the admission of children's medical insurance into hospitalized medical insurance, this desire became a reality. "At present, the general outpatient service for inpatient medical insurance is available at the social welfare center that is bound to it. Therefore, children who participate in the insurance must also be bound to the social welfare center to enjoy the general outpatient service." The person in charge said that for children with illness The characteristics of diversity and complexity, in terms of binding social welfare, the policy has been relaxed, the insured children are divided into two situations: children under 14 weeks, the clinic can choose to bind a social welfare center, or Choose to bind to a hospital in the lower secondary or lower level hospital for medical treatment; for children over 14 weeks, the body development has been relatively perfect, the incidence rate is similar to that of adults, and it is the same as the adult insured person in the medical center.
The binding situation is not ideal for more than a month. The person in charge believes that the main reason is that some parents do not understand the policy. He called on parents who are insured for children to choose the social welfare center as soon as possible, and quickly handle the binding procedures, while the bindable hospital and social welfare center can be found on the website of the Social Security Bureau: www. Szsi. Gov. Query on cn.
After the social health, the general outpatient clinic can be accounted for reimbursement
. After the social welfare is attached, what kind of general outpatient treatment can the children enjoy? According to the current standard, according to the current standard, Class A drugs can be accounted for 80%, personally paid 20%, Class B drugs accounted for 60%, and individuals pay 40%; 120 or less medical treatments The fee is 90%, the individual pays 10%, and the medical expenses above 120 are accounted for 120. Outpatient blood transfusion costs are 70% booked, and individuals pay 30%. The total personal accounting for a social security year does not exceed 800.
"If in September, a child insured payment is successful, and the parents have already been bound to the social health center or hospital. From this month on, the child will go to the social health center and the hospital to see the general clinic. The person in charge can be accounted for for reimbursement." The person in charge reminded that after the medical insurance for children is incorporated into the inpatient medical insurance, the treatment enjoyment period is based on the provisions of the inpatient medical insurance, and the medical insurance benefits are paid from the full payment of the medical insurance premium. Instead of paying the monthly payment as the original month, you will enjoy the treatment.
Three ways to participate in the binding
At present, children under the age of 14 can choose to bind in three ways: the first time the insured person can choose the social welfare center or hospital near the place of residence when submitting the insured information; The website of the Social Security Bureau (www.szsi.gov.cn) selects the social security center or hospital near the place of residence through the personal online application system; it binds to the nearest street, community or social security agency.
Children who have been enrolled for more than 14 weeks can also choose to bind in three ways: directly to the social welfare center to be bound; to log in to the website of the Social Security Bureau, and to link to the outpatient clinic through the personal online application system. The person who is insured for the first time can choose the social welfare center that is bound to the clinic when submitting the insured information.
The social health center or hospital where the outpatient clinic is attached must not be changed within one month after the designated medical institution is in contact with the child. But after 1 month, you can re-select a new social health center or hospital.