Can the medical insurance card be used universally in the province?

Whether the medical insurance card is universal in the province depends on the local medical insurance policy. Under normal circumstances, medical insurance can only be used in the city where the insured person is located. If you are in a different place, you can enjoy it unless you apply for referral or emergency hospitalization.

Overall policy of medical card in Anhui province

Anhui Provincial Department of Human Resources and Social Security announced that the medical insurance card will be universal in the whole province. It is reported that this is the successful completion of two-way online settlement of medical treatment in different places in Anhui Province. From now on, the medical insurance participants in the whole province can go to designated medical institutions in other cities in the province outside the insured place, and they can be reimbursed and settled immediately when they leave the hospital, without paying medical expenses in advance, which greatly reduces the payment burden of patients.

Medical insurance card is universal in the whole province

The medical insurance card will be universal in the province, and the medical insurance participants in the province will go to designated medical institutions in other cities in the province outside the insured place for medical treatment, without prepaid medical expenses, and they can be reimbursed and settled immediately when they leave the hospital, greatly reducing the payment burden of the sick people.

Provincial medical insurance card settlement

Start online settlement of basic medical insurance for medical treatment in different places. Taking the mode of pilot first and phased work, one-way online real-time settlement of medical treatment in different places in the province was realized on February 8, 20 13, and the task of "fully realizing medical treatment settlement in different places in the province within the year" was completed ahead of schedule.

An example of medical insurance card not being universal in the whole province

For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Someone spent a total of 9000 yuan on medical expenses, and the reimbursement formula is as follows: (9000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. In addition, it is also important to go to designated medical institutions for medical treatment.

The general problem of medical insurance card has not been realized for the following reasons:

First of all, medical insurance involves urban and rural planning, regional planning and information construction, and there are regional differences in the payment amount, payment method and proportion of medical insurance and medical insurance catalogue. At the same time, in order to prevent fraudulent insurance and abuse of medical services and supervise medical behavior, the authenticity of medical service information should be audited in medical insurance settlement.

Real-time settlement of medical treatment in different places needs to change the manual audit of medical treatment information in different places into electronic audit. This requires the networking of thousands of institutions and tens of thousands of medical institutions across the country to realize the standardization and unification of information. Therefore, the national popularization of medical insurance card is a huge systematic project, which takes a long time.

Secondly, if we want to realize the national standardized medical insurance system, we need to do it in stages, first at the prefecture level, then at the provincial level, and finally realize the national transfer and universal medical insurance.

Thirdly, China currently implements three different insurance systems: basic medical insurance for urban workers, basic medical insurance for urban residents and new rural cooperative medical care. There are overlaps and differences among the three basic medical insurance systems, so it is difficult to manage them in a unified way. Even the inter-provincial real-time settlement in the Yangtze River Delta Economic Zone is only for the insured of basic medical insurance for urban workers. The unified management of medical insurance is very important if it is coordinated and transferred nationwide.

Baidu encyclopedia-medical insurance in different places