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Where can I get the Basic Medical Insurance Special Disease Outpatient Application Form in Qinhuangdao?
1. Bring your ID card, medical record and medical guarantee, and get the application form from the Medical Insurance Office of the third-level designated hospital. After filling out the form, go to the third-level designated hospital for identification. After the doctor signs the opinion, it is submitted to the medical insurance office for identification and signature.

2. The insured person holds the Application Form for Outpatient Treatment of Special Diseases, the Medical Insurance Certificate and relevant medical records to the medical insurance office of the designated hospital for outpatient treatment of special diseases that I choose and meet the conditions.

3, special disease outpatient treatment by the designated hospital medical insurance office unified sent to the provincial medical insurance center.

The expenses that can be reimbursed after handling this medical expense are a little more. However, your father's situation, the provincial medical insurance center has the final say, and they have the final say.

I suggest you ask the provincial medical insurance center first, and then handle it.

Extended data:

Declaration procedure:

1, preliminary declaration.

The insured units or individuals who apply for the first time shall, before the last month of each quarter 15, hold the form of the medical insurance department of the first-instance hospital and fill in the application form for special disease outpatient service, prepare the relevant medical records (or copies) of the declared diseases and a recent 1 inch bareheaded photo, and choose designated hospitals and special disease outpatient pharmacies for medical treatment.

The special declaration of resettlement personnel in different places shall be handled by the medical insurance administrator of the unit or myself in the medical insurance department of the special trial appraisal hospital at the corresponding level in this city.

2. Preliminary examination of the hospital. After the first-instance hospital collects all the relevant information of the applicant, it will organize medical experts in our hospital to make diagnosis and preliminary identification.

3. Expert review. At the end of each quarter, the municipal medical insurance department organizes the expert committee of the basic medical insurance for urban workers in this Municipality to conduct centralized review, and the expert committee will review them one by one according to the special confirmation standards.

4, the issuance of "special outpatient medical records of special diseases". After passing the review by the Municipal Expert Committee, special applicants will bring the medical insurance manual to the Municipal Medical Insurance Office to receive special medical records for special disease clinics within 5 working days in the first month of the next quarter. Those who pass the review will begin to enjoy the basic medical insurance special disease outpatient treatment that month. If the evaluation by the Municipal Expert Committee is unqualified, it shall indicate the reasons for the unqualified and inform it in writing, and return the medical records to the applicant.

5, special disease renewal procedures. The period of validity of special disease A and B clinics is two years, and that of class C is one year. If the illness is not healed and needs treatment, it is necessary to go through the renewal procedures.