Can cross-provincial hospitalization be directly reimbursed?

Cross-provincial hospitalization can be directly reimbursed. Specific operation mode:

1. After the treatment, you can ask the hospital for outpatient records, inpatient medical records and other related materials;

2. Submit the above materials and invoices. Go to the social security agency of the original insured place or the management department of the medical insurance fund for urban and rural residents, and apply for direct settlement or reimbursement before subsidizing; Please note that the proportion and amount of reimbursement may vary by region, policy and participation type.

Inter-provincial medical insurance reimbursement methods are as follows:

1. Emergency hospitalization expenses incurred in different places due to business trip, family visit, vacation and other reasons under special circumstances. Reimbursement shall be made in accordance with the specific provisions of the medical insurance measures of the insured place. Generally, in an emergency, the nearest diagnosis and treatment is allowed. After treatment, with the valid certificate issued by the treatment hospital, it will be reimbursed to the local medical insurance agency according to the regulations;

2. If you have retired and your children have settled in other places, you can go back to the medical insurance center of the insured area to handle the resettlement of retirees in different places. After you do a good job, you can choose one or two designated hospitals for medical treatment, and the expenses will be paid by yourself first, and then reimbursed by the medical insurance center in the insured area;

3. For employees who have been overseas for a long time, they can also apply for medical insurance resettlement in different places, and the unit can apply. After doing well, they can choose one or two designated hospitals for medical treatment, and the expenses will be paid by themselves first, and then they will be reimbursed by the medical insurance center in the insured area.

Medical insurance reimbursement process in different places:

1, medical treatment in different places needs to be approved by relevant departments first. The examination and approval place for resettlement in different places is the county medical insurance center where the insured unit or street social security is located. After applying for the relevant approval form, fill in the relevant contents. Take the relevant documents to the medical insurance department of a different hospital and stamp them. Then return the relevant approval form to the applicant for approval;

2. The time limit for examination and approval in different places is generally one year, that is, from the date of handling to the date of the second year. You can't change it within a year. If the approval period has passed, the parties who are still in different places need to go to the relevant departments for re-approval. For the parties in different places, it is essential to choose a different hospital. The regulations on how many hospitals patients can choose in different regions are different. Generally, you can choose two or three;

3. It is essential for people who seek medical treatment in different places to meet reimbursement in different places. Relevant personnel need to go to outpatient department and hospital to issue receipts, lists, prescriptions, details, medical insurance manuals and case diagnosis certificates. The more detailed, the better. At the same time, don't forget to issue the registration certificate of the hospital where you go to see a doctor, so that employers, social security offices and district and county medical insurance centers can make statistical summary and audit settlement;

4. For the medical expenses incurred by the parties in designated hospitals in different places, mail the relevant reimbursement documents back to the original city for reimbursement, or ask family members to help with reimbursement in the original city. Issues such as reimbursement standards will still be in accordance with the regulations of the city, and relevant funds can be collected by family members or related accounts can be set up.

To sum up, the discharge summary, invoice and medication list issued by different hospitals. And bring my ID card, medical insurance card and medical certificate issued by the unit. 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 the transfer certificate is handled at the hospital medical insurance office.

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.

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.