Xiamen medical insurance reimbursement process for medical treatment in different places

Legal analysis: 1. Cross-provincial medical treatment in different places is in line with the national settlement platform, and no longer "running errands" and "paying bills"!

After filing, inter-provincial hospitalization medical expenses were settled in real time, which greatly reduced the transportation cost, time cost and financial pressure caused by reimbursement of medical expenses between the two places.

2. The filing institution simplifies the confirmation procedure, which is more convenient.

The original medical records in different places must be reviewed and confirmed by medical insurance agencies in different places, and medical institutions and retail pharmacies should be selected as designated medical institutions for local medical insurance, and the hospital level should be defined. To simplify, if the selected designated medical institution is a designated medical institution for direct settlement of medical treatment in different provinces and places, and it is made public on the national networking platform or official website (Http//si. 12333.gov.cn), the medical insurance agency in different places may not need to confirm.

3. The time limit for filing changes is reduced from 6 months to 3 months, which is more humanized.

According to the original regulations, retirees, long-term residents in different places and permanent residents in different places may not cancel their registration or change designated medical institutions and retail pharmacies in different places within 6 months from the effective date of medical treatment in different places. Considering that transportation is more convenient and people flow is extremely convenient, the time limit is shortened to three months.

4. After filing, you can return to Xiamen for a short time to resume swiping your card, which fully considers the needs of the insured.

Those who return to the city in a short period (within 3 months) can apply for opening a local credit card, and the medical insurance agency will suspend their medical records in different places and open the real-time settlement function of the credit card in this city until they leave this city.

5. Filing can be handled nearby, which is more convenient.

Resettlement of retirees, workers in different places and long-term residents in different places shall be filed at the front desk. At present, the insured can go to the business window of the administrative service center of the municipal or district medical insurance agency nearby. (Previously, it was necessary to go to the medical insurance agency in the area where the account was located)

Legal basis: Article 5 of the Administrative Measures for Medical Treatment in Different Places of Basic Medical Insurance in Xiamen, retirees, long-term residents in different places and permanent residents in different places can choose three local designated medical institutions for medical treatment, choose a local designated retail pharmacy to buy medicines, and go through the medical treatment procedures in different places according to the following procedures:

(a) the applicant can download and fill in the "Xiamen basic medical insurance resettlement and work record form"; (hereinafter referred to as the filing form)

(two) work in different places for the record, the insured units need to confirm;

(three) medical institutions and retail pharmacies selected by medical insurance agencies in different places have been confirmed as designated medical institutions for local medical insurance after examination, and the hospital level has been clarified. The selected designated medical institutions are designated medical institutions for direct settlement of medical treatment in different provinces and places, which are made public on the national networking platform or official website (Http//si. 12333.gov.cn), and the medical insurance agencies in different places do not need to confirm;