Can the outpatient service in different places be settled directly by medical insurance card?

Off-site clinics can be settled directly with medical insurance cards.

Living in a different place for a long time meets the requirements of the insured place. Such people need to apply for resettlement and filing in the insured place, be hospitalized in a hospital that is included in the settlement system for medical treatment in different places, and directly settle medical expenses with their new social security card.

The conditions for directly applying for settlement of medical insurance reimbursement for outpatient clinics in different places are as follows:

1. Resettlement of retirees in different places: those who have settled in different places after retirement and whose household registration has moved to their place of residence;

2. Long-term residence in different places: refers to people who live in different places and meet the relevant regulations of the insured place;

3. Resident in different places: refers to the personnel who are sent by the employer to work in different places and meet the relevant regulations of the insured place;

4. Referral and referral personnel: refers to those who meet the conditions of referral and referral in the insured place;

5. Other personnel: refers to the personnel who meet the requirements of the insured place for outpatient treatment and drug purchase in pharmacies in different places.

The reimbursement process of medical insurance in different places is as follows:

1, get basic medical insurance for people working and living in different places;

2, according to the provisions of the declaration form, stamped by the foreign medical insurance agencies;

3. Take the completed declaration form back to the social insurance agency responsible for the division of labor for review and confirmation. If you need to apply for a medical card in the province, you should register with the audit department of the municipal social security center with the declaration form after examination and confirmation, and then go to the social security card management department to handle the business card printing procedures for the networked cards in different places in the province.

To sum up, medical insurance filing is mainly aimed at the direct settlement of hospitalization expenses when the basic medical insurance is treated across provinces or regions.

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

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.