Zhuhai Medical Insurance Reimbursement Policy in 2023

The reimbursement policies for medical insurance in Zhuhai in 2023 are as follows:

1. Scope of medical treatment in different places: public medical institutions and some cooperative medical institutions in the whole country outside the insured place (Zhuhai);

2. Direct settlement scope: When the insured provides medical services in the above-mentioned designated medical institutions, they can use personal social security cards for direct settlement;

3. Reimbursement ratio: Insured persons who seek medical treatment in different places can enjoy the same medical treatment as local residents, and the medical insurance fund will reimburse them according to the local reimbursement ratio.

The specific implementation rules of the direct settlement policy for urban employees' basic medical insurance in Zhuhai may be different. It is recommended that you know the latest local policies and regulations in advance and consult the local social security department or medical insurance department in order to enjoy medical insurance benefits smoothly.

Medical insurance off-site reimbursement process:

1, discharge summary, invoice and medication list issued by different hospitals;

2. My ID card, medical insurance card and medical certificate issued by the unit. Non-enterprise insured, no need to issue a certificate of medical treatment in different places issued by the unit;

3. The transfer certificate issued by the local hospital needs to be issued by the attending physician, and then signed by the director of the department where the attending physician is located, and then go to the hospital medical insurance office to handle the transfer certificate;

4. The reimbursement for returning to the local area for medical treatment in different places is less than that in the local area 10%, and there is 20% less without the transfer certificate issued by the local hospital;

5. Bring the above information to the local medical insurance office, and you can get the money on the same day.

To sum up, different regions and different types of medical insurance reimbursement may have different specific processes and requirements, and the insured personnel need to operate according to local regulations. At the same time, when enjoying the medical insurance reimbursement treatment in different places, when applying for reimbursement, it is necessary to keep relevant medical treatment and expense vouchers for certification.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.