Medical insurance reimbursement process for medical treatment in different places

Legal analysis: 1, long-term residence in different places for medical treatment

(1) Registration and filing

The insured person shall fill in the registration form for medical treatment in different places of basic medical insurance in accordance with the provisions of the place where medical insurance is insured, and provide his ID card, social security card and proof of long-term residence in different places. Online filing, login to official website Social Security Bureau to fill in the filing information, offline filing, and fill in the filing registration form at the local social security bureau.

(2) Select a point

Be sure to choose a designated hospital for filing, because patients can only enjoy medical insurance reimbursement in different places if they register in a designated hospital. If you don't know which hospitals can settle accounts in different places, you can log on to the social security network to inquire.

(3) Holding a card for medical treatment

As long as the insured completes the registration, goes to the designated hospital for medical treatment, and then carries the social security card for admission registration and discharge settlement, the medical expenses can be settled directly without advance payment. So you must remember to bring your own medical insurance card when you see a doctor.

2. Referral to different hospitals for treatment

When referring to a hospital in a different place for medical reimbursement, the local hospital needs to issue a "referral and transfer certificate" to go through the formalities of medical treatment in a different place.

It should be noted that it is more important to find a hospital to issue a "referral and transfer certificate", and "referral and transfer" should also meet the three conditions of "step-by-step treatment, expert review and two-way referral".

To put it simply: local hospitals are unable to treat hospitals whose causes cannot be found in the top three hospitals, so they are referred to hospitals with higher treatment level.

3. Go out for temporary medical treatment in different places

If it is a temporary emergency, hospitals in many cities now support "treatment first, then reimbursement", but the proportion of reimbursement will decrease.

If it is an ordinary outpatient clinic, the cost is relatively small, you can keep the bill and return it to the insured place, and then submit the information for reimbursement.

If the cost of treatment is relatively high, you can first register with the social security filing bureau of the insured place (telephone filing is supported), and then reimburse according to the standard of referral certificate after the disease is cured (treatment fee is paid in advance).

It is not easy to seek medical reimbursement in different places. Friends who need medical reimbursement in different places must know the relevant matters in advance before seeing a doctor.

It should be noted that the premise of medical insurance reimbursement in different places is that it is normal to participate in insurance if the medical insurance expenses have been paid. Failing to pay the medical insurance fee on time, you can't use the medical insurance reimbursement function in different places.

Legal basis: Article 23 of the Social Insurance Law of People's Republic of China (PRC), employees shall participate in the basic medical insurance for employees, and both employers and employees shall pay the basic medical insurance premium according to the provisions of the state. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

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The above answer is only for the current information combined with my understanding of the law, please refer carefully!

If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.