The latest policy of medical insurance reimbursement in different places in 2023

The new policy of medical treatment in different places in 2023 is as follows:

1, the scope of medical personnel in different provinces has expanded.

Before the reform, there were four types of personnel: resettling retirees in different places; Living in a different place for a long time; Resident in different places; Referral of medical staff from different places.

After the change, it is divided into two categories: the first category of inter-provincial permanent residents includes retirees resettled in different places; Living in a different place for a long time; Resident in different places; The second category of inter-provincial temporary medical personnel includes those who are referred to other places for medical treatment; Emergency rescue personnel in different places due to work, tourism and other reasons; Other inter-provincial temporary medical personnel;

2. The validity period of medical treatment in different provinces is different.

After the inter-provincial permanent residents register for the record, the record is valid for a long time, and the number of visits is not limited.

In principle, the validity period of inter-provincial temporary medical personnel is not less than 6 months. During the validity period, they can see a doctor many times in the medical place and enjoy the direct settlement service of cross-provincial medical treatment in different places, without a medical record.

3. It is more convenient to seek medical treatment across provinces.

The filing channels have been further broadened; The coverage of medical treatment in different places has been further expanded; You can seek medical treatment in different places with a code;

4, clear inter-provincial temporary medical personnel reimbursement policy.

The reimbursement standard for inter-provincial temporary outpatient medical treatment can be lower than the reimbursement level of medical institutions at the same level in the insured area. In principle, the reduction of the payment ratio of referral personnel from different places and emergency rescue personnel shall not exceed 10 percentage point, and the reduction of the payment ratio of other inter-provincial temporary outpatient medical personnel for non-emergency referral shall not exceed 20 percentage points.

5. Support long-term residents to enjoy two-way treatment across provinces.

In order to meet the actual needs of long-term residents across provinces to return to the insured place for medical reimbursement due to visiting relatives and other reasons, long-term residents across provinces are allowed to enjoy treatment at both the filing place and the insured place.

If it is really necessary to go back to the insured place for medical treatment within the validity period of inter-provincial permanent residents' filing, you can enjoy the direct settlement service of medical insurance in the insured place, which is not lower than the inter-provincial referral treatment level in principle;

6. It can be solved directly, because the emergency department has no time to file a case.

Emergency rescue expenses are included in the scope of direct settlement of inter-provincial medical treatment in different places, and emergency personnel in different places are regarded as having been filed, and there is no need to provide additional filing materials, so as to realize direct settlement of inter-provincial medical treatment in different places according to the relevant treatment standards of the insured places;

7. You can have medical records in different places.

Unable to go through the formalities for filing, the insured shall go through the formalities for filing and registration from the date of admission before the inter-provincial discharge settlement, and the designated medical institutions in different places shall provide direct settlement services as required; If the insured person is discharged from the hospital at his own expense, he can go through the registration formalities at the medical insurance agency in the insured place and apply for manual reimbursement;

8, do not belong to the third party's responsibility for trauma expenses included in the scope of medical insurance reimbursement.

Traumatic medical expenses without third-party liability that meet the requirements of medical treatment management can be included in the direct settlement scope of medical treatment in different provinces. After signing the trauma commitment letter without the third party's responsibility, the insured can directly swipe the card at the medical place to settle the expenses without applying for reimbursement at his own expense.