Proportion of reimbursement for medical treatment in different places outside Shandong Province

According to the medical insurance policy, the reimbursement rate of medical expenses directly settled by holding social security cards in designated medical institutions in different places is reduced by 5 percentage points according to the level of medical institutions. For the insured who have not gone through the formalities of medical treatment in different places, the reimbursement ratio will be reduced by 10 percentage point.

The medical insurance policy stipulates that when the insured seeks medical treatment in different places, they should first choose the designated medical institutions that have opened direct settlement for medical treatment in different places. The reimbursement rate of medical expenses directly settled in medical institutions with social security cards is the same as that of the insured in the province, but it will be reduced by 5 percentage points according to the level of medical institutions. For the insured who did not go through the formalities of medical treatment in different places, the reimbursement ratio was further reduced by 10 percentage point.

In order to ensure a reasonable reimbursement rate for medical treatment in different places, it is suggested that the insured take the following measures:

1. Know the relevant policies and regulations of medical treatment in different places in advance, including the designated medical institutions for medical treatment in different places, reimbursement ratio, required materials, etc.

2. If you need to go to a different place for medical treatment before, you should go through the formalities for medical treatment in a different place in time so as to be reimbursed according to the prescribed reimbursement ratio.

3. When seeking medical treatment in different places, choose a designated medical institution that has opened direct settlement for medical treatment in different places, so as to be able to directly settle medical expenses with social security cards.

4. Understand the level of medical institutions, so as to understand the adjustment of reimbursement ratio during settlement.

5. Keep relevant medical expense invoices, medical records, prescriptions and other materials properly, so as to provide complete reimbursement materials when necessary.

To sum up, in order to ensure a reasonable reimbursement rate for medical treatment in different places, the insured needs to understand relevant policies and regulations, comply with requirements, choose appropriate medical institutions, and properly keep relevant information.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.