How to reimburse Nantaihu Insurance?

The insurance period of "Nantaihu Health Insurance" this year is from January 1 to December 31, 2021. Currently, "Nantaihu Health Insurance" is undertaking *** insurance under the guidance of the municipal medical insurance department. Let’s do a good job in claims settlement. Let’s talk to you today about how to reimburse Huzhou Nantaihu Health Insurance? What are the insurance requirements? If you are interested, let’s take a look

1. One-stop settlement

When the insured incurs medical expenses within the scope of the South Taihu Health Insurance during the insurance period, after the payment period, the commercial insurance company and the Medical Insurance Bureau will conduct one-stop settlement through the medical settlement data of the medical insurance information system. < /p>

2. Sporadic reimbursement settlement

If the medical expenses incurred by the insured during the insurance period do not meet the requirements of one-stop settlement, then you can use sporadic reimbursement with relevant materials. Special windows are set up at designated outlets for processing.

Note: The insurance period of this product is from January 1 to December 31, 2021, which means that as long as the medical expenses incurred this year are within the scope of liability. , after enrolling in Nantaihu Health Insurance and the payment period has passed, these expenses can still be reimbursed.

What are the requirements for Nantaihu Health Insurance in Huzhou?

The insurance is a people-beneficial insurance, so its insurance requirements are very loose. As long as you are a participant in the Huzhou City Basic Medical Insurance (including the Urban Employees Basic Medical Insurance and the Urban and Rural Resident Basic Medical Insurance), you can purchase it without any restrictions on age, occupation, or household registration. There are no requirements for the health status of the insured. You can be insured even if you are sick, and you can also pay for pre-existing conditions. Whether it is a newborn, the elderly, patients with pre-existing conditions, or high-risk occupational groups, the insurance only costs 100 yuan/year. .

How much does Huzhou Nantaihu Health Insurance reimburse?

Let us give an example of how much it reimburses

If Mr. Wang buys Nantaihu Health insurance: I was diagnosed with lung cancer for the first time in August. I was hospitalized in a tertiary hospital in Huzhou City. I spent 1 million yuan per day. After being reimbursed by the medical insurance, I still have to bear 650,000 yuan, of which the individual pays 350,000 yuan out of the medical insurance. After being discharged from the hospital, he needed to use Taishengqi, a special drug for treating lung cancer, which cost him 300,000 yuan out of pocket.

So, Mr. Wang spent 100,000 yuan on it. Taihu Health Insurance can reimburse you as follows:

● Hospitalization expenses covered by medical insurance: (350,000-5,000 deductible) * 50% = 172,500 yuan

● Drug list expenses outside medical insurance: (140,000-10,000 deductible)*50%=65,000 yuan

● High-value drug expenses: (100,000-10,000 deductible)*50%=45,000 yuan

● One *** reimbursement: 282,500 yuan

In this way, after Mr. Wang is reimbursed by medical insurance, he can reimburse 282,500 yuan through South Taihu Health Insurance, which greatly relieves Mr. Wang’s burden