Wujiang medical insurance reimbursement policy conditions

1, Wujiang's medical insurance can be swiped in Suzhou, and Suzhou's medical insurance cannot be swiped in Wujiang for the time being.

2. Wen Xin, director of the Medical Insurance Department of Suzhou Human Resources and Social Security Bureau, said that according to China's policy, Suzhou and Wujiang belong to two different medical insurance co-ordination areas. Suzhou medical insurance is mainly divided into two parts: employee medical insurance and resident medical insurance. The former is mainly funded by units and individuals, while the latter is funded by individuals and financial subsidies. Wujiang medical insurance is also two major sources of financing, but according to local conditions, the specific medical insurance policies, standards and treatment are somewhat different from Suzhou. "Simply put, if you look at the same disease in Suzhou and Wujiang, the reimbursement ratio of the same project may be different." Moreover, there are many differences in hardware and software equipment and ports of the medical insurance information system between the two places.

3. Why can residents of Wujiang District come to Suzhou for medical treatment with Wujiang Medical Insurance Card? Wen Xin explained that there is no third-class first-class hospital in Wujiang District, so in order to facilitate local residents to see a doctor, the "Wujiang Medical Insurance Suzhou Special Line" was opened in several major hospitals in Suzhou last year, such as the First Affiliated Hospital of Suzhou University and Suzhou Municipal Hospital. On the surface, residents in Wujiang District directly swipe their cards to see a doctor in these hospitals. In fact, the relevant information is transmitted back to Wujiang social security department through specially laid optical fiber, and it is still settled according to local policy standards, "which is an expedient measure".

4. Wen Xin said that Wujiang has been out of the city for almost two years, but it will take several years for Suzhou and Wujiang to realize the seamless connection of medical insurance and the unification of medical insurance policies, settlement standards, management and information systems. At present, the social security department is trying to make Wujiang's medical insurance policy consistent with Suzhou's medical insurance policy, creating conditions for the next integration.

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