First of all, I would like to clarify 3 points. 1. The following explanations of medical insurance policies are obtained from http://www.bjld.gov.cn/csibiz/home/ (Beijing social insurance network service platform).
I am not aware of the insurance policies of public health insurance, Beijing Agricultural Cooperative Insurance, commercial insurance, or insurance for foreign patients, so please consult the participating institutions if you can apply for “special diseases”.
3.The original medical insurance policy for special diseases in Beijing can be found at: http://www.bjld.gov.cn/csibiz/home/static/articles/catalog_75800/2011-08-16/article_ ff80808130e8e3660130f7f92856024a/ff80808130e8e3660130f7f92856024a.html I. What diseases can I apply for special diseases?
“Patients with malignant tumors requiring radiotherapy and chemotherapy, renal insufficiency requiring long-term dialysis, and patients requiring long-term anti-rejection therapy after kidney transplantation” can apply for special diseases.
Among the patients treated by our gastrointestinal specialty group, patients with malignant tumor of stomach, malignant tumor of colorectum, malignant tumor of small intestine, malignant tumor of appendix and malignant tumor of abdominal cavity can apply.
II. What are the benefits of applying for special diseases and why should I apply?
Gastrointestinal malignant tumor requires frequent outpatient prescriptions and review, and the maximum annual reimbursement limit for general medical insurance patients is 20,000 RMB.
3. How to apply for special diseases?
①First of all, please ask the patient’s family to go to the customer service center on the north side of the first floor of our hospital outpatient clinic (the lobby where the specialist’s number is registered) to get a special disease application form (three copies) ②Go back to the ward and ask the doctor in charge to fill out and stamp it.
③ according to the application form one by one by the hospital, the unit, the district medical insurance stamp.
④ one copy to keep in the district medical insurance department, one copy to keep by themselves, and one copy to the special disease window on the 5th floor of the outpatient clinic.
How to get reimbursed after the procedure?
When you see a doctor in the future, please go to the special disease window on the 5th floor of the outpatient clinic to get the part about tumor reimbursed for special disease, and the part not related to tumor will be set aside and paid according to the proportion of general medical insurance.
V. Can I be reimbursed for special diseases in all hospitals after I have applied for special diseases?
No, the special disease is only applicable to the hospital you declared, but it cannot be reimbursed as special disease in other hospitals. However, you can change the policy. Please call the district medical insurance department for details of the change policy.
6. Is it valid for a long time after the declaration?
No, it is valid for one year, and you need to renew it after one year. Please bring the copy of the application form you have kept, and get a new application form from the outpatient clinic and fill it out with the doctor in charge in the ward. For efficiency, please bring your own copy of the application form, as I am afraid no one can remember the details of the surgery 1 year ago, so please understand that it is difficult to check.
Lastly, I am afraid that families who have applied for special diseases will understand the policies and procedures better than I do, so if there are any mistakes in the above explanation, I hope you will bring them up so that the families of the patients will not take a wrong turn.