Recently, many small partners have been consulting in the background about medical treatment in different places.
Recently, the state issued the Notice on Further Improving the Direct Settlement of Medical Treatment in Different Provinces of Basic Medical Insurance. This notice will officially implement the 1 unified settlement policy for medical treatment in different places from 2023.
In response to this document, we have sorted out the five major benefits that have the greatest impact on everyone, as well as the latest medical treatment filing process in different places.
The main contents of this paper are as follows:
Five advantages of medical treatment in different places
Three steps to easily obtain medical records from different places
How to reimburse for medical treatment in different places? How much can you quote?
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Five advantages of medical treatment in different places
The most troublesome thing about seeing a doctor in other provinces is reimbursement.
Workers who work outside the home, office workers who travel for a long time, retired people who help to take care of their children in big cities, and people who need to go to other provinces for medical treatment because of limited local medical conditions will all have five advantages in seeking medical treatment in different places from next year:
1. Out-of-town clinic, most areas support direct reimbursement.
This new regulation stipulates that in the future, more and more hospitals will be able to reimburse general outpatient services and five kinds of outpatient services for chronic diseases and special diseases.
(The five outpatient clinics for chronic diseases include: hypertension, diabetes, radiotherapy and chemotherapy for malignant tumors, uremia dialysis and anti-rejection treatment after organ transplantation)
2. After filing in different places, you can also use medical insurance when you go back to your hometown to see a doctor.
According to the previous regulations, if you have already gone through medical treatment in different places, you can only use medical insurance at the place of filing. If you go back to your hometown to see a doctor, you must cancel the record before you can use medical insurance.
Next, for people who live across provinces for a long time, as long as they are in the validity period of filing, they can use medical insurance whether they are in the filing place or going back to their hometown (the insured place).
3. On-site emergency rescue, without filing.
Starting from next year, if there is a sudden illness or accident in other places, it can also be directly reimbursed by medical insurance if it is too late to file in advance.
4. You can also fill in the records before leaving the hospital.
If it's not an emergency/rescue, and no records were made before hospitalization in other places, it won't affect the reimbursement as long as a medical record is made up in other places before discharge.
5, long-term inter-provincial residence, a long recording time.
The new regulations stipulate that friends who live in other provinces for a long time will have long-term records. For friends who go out for medical treatment temporarily, the filing period is not less than 6 months, and there is no limit on the number of medical visits within the validity period.
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Three steps to easily obtain medical records from different places
Filing in different places is very simple, only three steps are needed: filing, determining the hospital and holding a card for medical treatment.
Step one: put it on record
There are two main ways to record medical treatment in different places, one is to go directly to the social security bureau of the insured place, and the other is to go directly online. Now many places can operate directly with mobile phones.
Let's take the "National Medical Insurance Service Platform" app as an example to show you the detailed operation process:
Step 2: Determine the hospital.
Ensure that after the hospital completes the filing, it can only be reimbursed directly with the medical insurance card if the hospital has opened the direct settlement service for medical treatment across provinces and different places.
Therefore, before we go to see a doctor, we must determine whether the hospital can directly settle accounts and which expenses can be reimbursed. This information can also be found on the "National Medical Insurance Service Platform" app.
Step 3: Get a card for medical treatment.
After completing the first two steps, you can go to the hospital. It doesn't matter if you forget to bring your social security card. You can directly use the electronic social security card on your mobile phone or show your medical insurance code, and you can brush your medical insurance.
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How to reimburse for medical treatment in different places? How much can you quote?
Say the original text first:
Translate this reimbursement rule for everyone in vernacular.
What expenses can be reported depends on the medical insurance catalogue of the medical treatment place: for example, drugs, medical treatment items, service facilities, etc. Belonging to the medical insurance catalogue can be included in the scope of reimbursement;
How much you can report depends on the policies of your hometown (the place where you are insured): for example, the deductible line for reimbursement, the proportion of reimbursement, and the maximum amount.
In other words, whether the expenses can be reported depends on the policy of the medical treatment place; How much can be reimbursed depends on the policy of the insured place.
Let me give you an example to understand:
Aunt Wang paid social security in her hometown of Wuhan. After retirement, she helped with the children in Shenzhen. Recently, she went to a 3A hospital in Shenzhen and spent more than 30,000 yuan. If she goes through medical records in different places, let's see how to reimburse her:
1 According to Shenzhen's policy, see which ones can be reimbursed: for example, if there are 20,000 expenses in Shenzhen's medical insurance catalogue, then this 20,000 can be reimbursed by medical insurance.
2 Look at the policy of my hometown Wuhan, how much can I reimburse: 800 yuan, the deductible line of Wuhan 3A Hospital, the reimbursement ratio is: (20,000-800 deductible line) * the reimbursement ratio is 1 10,000.
Of course, local medical insurance policies are different, and the actual reimbursement amount is different. If necessary, you can consult the local social security bureau or medical insurance department.
Let's share the process of medical treatment in different places. If today's sharing is useful to you, just click "Watch" at the bottom of the article and welcome to forward it to friends and relatives in need.
Source: Cunzhen Baoping, local medical insurance official website
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