Reference: "Instructions for Hospitalization of Medical Insurance Patients" of Hebei Provincial Hospital of Traditional Chinese Medicine

1. Before medical insurance patients go through hospitalization procedures, the first visiting doctor will check the person, certificate, and book, and Indicate the payment method (provincial medical insurance, municipal medical insurance, public medical insurance, cooperative medical insurance, self-paid medical treatment or others) in the upper left corner of the hospitalization certificate. Sign and stamp your signature before going to the hospitalization office to complete the hospitalization procedures to prevent impersonation; patients with provincial and municipal medical insurance When going through hospitalization procedures, you need to present your hospitalization certificate, medical guarantee (medical insurance medical record with personal photo) and pay part of the hospitalization deposit (2,000-5,000 yuan). The nurse in charge of the inpatient ward will verify the patient's height and weight again and sign for confirmation to prevent insurance fraud. Medical guarantees or medical insurance medical records with personal photos will be collected by the ward nurse in charge.

2. During hospitalization, strictly abide by the relevant regulations on medical insurance management, adhere to the principle of "guaranteing basic medical care, reducing costs, and reducing waste", use drugs rationally, and provide reasonable treatment. It is strictly prohibited to exchange drugs or medical items.

3. Those who need large-scale special examinations, special treatment items, valuable disposable sanitary materials (more than 1,000 yuan) and internal materials, referrals to hospitals and external examinations and external treatments must be approved before use. Otherwise, the medical insurance fund will not pay for the expenses incurred. Commonly used materials inserted into the body include: pacemakers, artificial valves, artificial joints, intraocular lenses, various stents, various staplers, various catheters, landfill drug delivery devices, etc.

4. Bed fee: The medical insurance fund payment standard set by the Medical Insurance Center is: 45 yuan for a 2-person room, 32 yuan for a 3-person room, and 24 yuan for a 4-person room. Any excess expenses will be borne by yourself.

5. The medical expenses incurred during hospitalization shall be borne by both the individual and the medical insurance center (the overall fund part) in proportion.

①Provincial medical insurance patient’s personal burden ratio (our hospital is calculated as a third-level hospital)

22% within 5,000 yuan (19% for retirement)

5,000-10,000 RMB 17% (retirement 14%)

12% for RMB 10,000 and above (retirement 9%)

Every time you are hospitalized during the year, there is a certain minimum payment standard for the overall fund payment (individual Burden standard):

First hospitalization: RMB 800 for non-civil servant benefits (RMB 700 for retired)

RMB 500 for civil servants (RMB 400 for retired)

100 yuan for people from seven aspects

Hospitalization here: 30% reduction in steps, the minimum is not less than 200 yuan

② Municipal medical insurance patient minimum payment standard (individual burden standard):

First hospitalization: 1,000 yuan (900 yuan for retirement)

Re-hospitalization: 30% reduction each time, with a minimum of not less than 200 yuan

Municipal medical insurance basic medical insurance every year (overall planning The maximum payment amount of the fund is 65,000 yuan, and the payment amount below 65,000 yuan to 200,000 yuan (enjoying civil servant treatment of 210,000 yuan) will be paid in full by the insured patient first. After the diagnosis and treatment is completed, the unit will provide medical records, IC cards, and medical expenses. Submit the receipt to the medical insurance center for reimbursement according to regulations.

Minimum payment standard for residents’ medical insurance patients: 900 yuan

The annual payment amount of the municipal basic medical insurance for residents (the highest overall fund) is 25,000 yuan, ranging from 25,000 to 75,000 yuan. The following parts, First, the insured patient will advance the full amount. After diagnosis and treatment, the unit will go to the medical insurance center for reimbursement according to regulations with medical records, IC cards, and medical expense receipts.

6. If you have any questions about the relevant regulations or policies of the basic medical insurance for employees during this period, please consult the Medical Insurance Office in time.

Detailed policy:

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