Can Zhejiang medical insurance be reimbursed for medical treatment in different places?

Zhejiang medical insurance can be reimbursed for medical treatment in different places.

The first is the reimbursement conditions for medical treatment in different places.

When Zhejiang medical insurance participants seek medical treatment in different places, they must meet certain conditions to enjoy reimbursement. Under normal circumstances, the insured person needs to go through the filing procedures for medical treatment in different places in advance in the medical insurance department, and can enjoy the direct settlement service for medical treatment in different places after filing. In addition, hospitals seeking medical treatment in different places need designated medical institutions for medical insurance, and medical expenses incurred by non-designated medical institutions are generally not reimbursed.

Second, the reimbursement process for medical treatment in different places

1. Record of medical treatment in different places: insured persons need to go to the medical insurance department or designated medical institution in the insured place for record of medical treatment in different places, submit relevant materials and fill in the record form. After successful filing, the insured can enjoy the direct settlement service for medical treatment in different places within the validity period of filing.

2. Settlement of medical treatment: When seeking medical treatment in different places, the insured person should carry valid certificates such as social security card or medical insurance electronic certificate, and go through the admission formalities at the designated medical institution of medical insurance. When leaving the hospital, the medical institution will directly settle the medical expenses, and the insured person only needs to pay the personal burden.

3. Reimbursement application: For medical expenses that cannot be settled directly, the insured needs to bring relevant materials (such as medical expense invoices, diagnosis certificates, prescriptions, etc.). ) go back to the medical insurance department of the insured place to handle the reimbursement procedures. The medical insurance department shall review the reimbursement amount according to the policy and deposit the reimbursement amount into the bank account designated by the insured.

Third, matters needing attention

1. Insured personnel should know the policy of medical treatment in different places in advance to ensure that the filing procedures are completed before medical treatment.

2. When seeking medical treatment in different places, you should choose a designated medical institution with medical insurance to avoid medical expenses that cannot be reimbursed.

3. The insured shall properly keep medical expense invoices, diagnosis certificates and other related materials for reimbursement.

To sum up:

Zhejiang medical insurance can be reimbursed for medical treatment in different places, but the insured must meet certain conditions and follow relevant procedures. Insured persons should go through the filing procedures in advance before seeking medical treatment in different places, choose designated medical institutions for medical treatment, and properly keep relevant materials for reimbursement. The medical insurance department will review the reimbursement amount according to the policy and provide convenient reimbursement services for the insured.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 29 provides that:

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.

Regulations of Zhejiang Province on Medical Security

Article 20 provides that:

The medical expenses incurred by the insured after filing in designated medical institutions in different places can be directly settled through the basic medical insurance fund.