The participation mode and treatment enjoyment of medical insurance for college students in Hangzhou
From September 1 2022, new college students can voluntarily choose whether to participate in the medical insurance for college students in the year of enrollment and enjoy the corresponding treatment according to the regulations without repeating the insurance:
(1) college students who did not participate in other basic medical insurance at the time of enrollment, who chose to participate in the medical insurance for college students in that year, can enjoy the medical insurance benefits for the remaining months of that year according to the regulations after payment, and the specific benefits are implemented according to the relevant policies of insurance conversion and transfer.
Those who have participated in the medical insurance for urban and rural residents in this Municipality can continue to enjoy the corresponding medical insurance benefits.
(3) Those who have participated in the medical insurance for urban and rural residents outside the city shall enjoy the medical insurance treatment in the insured place in accordance with the relevant policies and regulations of Hangzhou for medical treatment in different places.
College students' medical insurance cards can be used in different places. Need to go to other places for medical treatment, divided into three situations:
1. The first type is to seek medical treatment in other places after returning home in winter and summer vacations. Generally, as long as you bring the required materials afterwards, you can reimburse them. This situation applies to returning to the place of origin (where the family is located), and the school can issue relevant certificates;
2. The second is that during the non-winter and summer vacations, due to educational practice, project research, social investigation and other reasons, it is necessary to go out and go out to see a doctor (reimbursed by medical insurance card). This must be reported to Siming District Social Insurance Management Center in advance before you go out to reimburse related expenses after you return to Xiamen;
3. The third type is those who have been treated in other places but can't be treated. They need a certificate from a qualified medical institution (a hospital above the second level) and put it on record at the level of the municipal social security center. In case of emergency, the examination and approval procedures should be completed within 7 days after transfer, and the validity period of the examination and approval form is 60 days. This situation is suitable for returning to the place of origin (where the family is located), and the school can issue relevant certificates.
Hangzhou medical insurance reimbursement process;
First of all, we must ensure that our basic medical insurance benefits are normal and there is no interruption in participation. Timely insurance payment is the premise and obligation for us to enjoy medical insurance benefits. Don't wait until you get sick to join medical insurance. There will be a waiting period if you do not participate in the insurance in time according to the regulations. Remember a word, insure early when you are healthy and protect early when you are sick.
Then, as far as possible, choose a local regular hospital for treatment. If it is not necessary during the treatment, please ask the doctor to use the medical insurance catalogue drugs or treatment items for you as much as possible (there will be differences in the medical insurance catalogues of different provinces, but there is generally little difference), which can reduce the cost of reimbursing self-funded items in the future.
After the treatment, the individual shall pay all the medical expenses in full, and keep the original medical invoice, detailed list of medical expenses remittance, discharge summary, medical records, inspection reports and other medical documents (if you can't remember clearly, just keep all the information related to the treatment and bring it back), and remember to ask the hospital to issue emergency certificate and grade certificate.
After returning to Hangzhou, bring my social security card (or ID card), my bank card and the above information to the nearest medical insurance agency for reimbursement in time. If you entrust your relatives and friends to help, you need to provide your agent's social security card (or ID card). The staff will carefully check the information and accept it. After your medical expenses are reviewed, the reimbursement part will be sent to your bank card in time, and the reimbursement statement will be sent to your designated address.
note:
1. Emergency medical expenses incurred by medical institutions in municipalities directly under the central government, provincial capitals and cities under separate state planning shall be reimbursed by individuals first, and 10% shall be paid by itself.
2. Different levels of hospitals will have different reimbursement rates in different places. The higher the level, the higher the proportion of reimbursement borne by individuals. Of course, if the money is not bad or the hospital itself is level 3, there is no need to issue a grade certificate, and the reimbursement will be settled directly according to the level 3 standard.
Reimbursement ratio:
legal ground
People's Republic of China (PRC) social insurance law
Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.