New rules for new rules for medical treatment across provinces need to know

The National Medical Insurance Bureau and the Ministry of Finance issued the "Notice on Further Doing a Basic Medical Insurance Cross -Provincial Different Settlement Work" on July 26, and uniformly regulate the detailed rules for medical filing, fund payment, and collaborative business. An insured person who went out to seek medical treatment had an important impact.

How to apply for medical treatment directly for cross -provinces?

To put it simply, it is the first filing, selection point, and a code card to seek medical treatment.

Before medical treatment at a different place, insured personnel can go through online and offline channels such as the national medical insurance service platform app, the national medical treatment filing applet, the client applet of the State Council, or the window of the insured place. All cross -provincial -connected fixed -point medical institutions opened by the insured can enjoy direct settlement services for hospitalization expenses across the province; medical insurance electronic vouchers or social security cards should be presented when medical treatment.

Cross -provincial medical direct settlement payment policies can be understood as "medical land directory and place of participation in the place of insurance."

In other words, the scope of payment and relevant regulations stipulated in the medical place, including the scope of payment scope of basic medical insurance drugs, medical service items and medical consumables; Relevant policies such as limited amount, outpatient slow disease diseases.

How to apply for medical treatment for cross -provinces?

Except for the emergency rescue personnel in different places, they are deemed to have recorded. No materials are required, and other personnel need to provide medical insurance electronic vouchers, valid identity documents or social security cards, and filing forms.

In addition, retirees in different places must provide the "Homepage List" and their "resident population registration card" or personal commitment; long -term residents in different places must provide residence certificates or personal commitments; The unit dispatched a certificate, the certificate of the work unit in a different place, and the one or the individual's commitment of the work contract; the referral personnel must provide the referral materials issued by the designated medical institution prescribed by the participation place.

At present, all regions have opened online medical insurance service platform APP, national medical treatment applets, and small procedures for the State Council client. Essence

In addition, 120 overall regions in the country have achieved self -service filing, and insured personnel can handle and take effect immediately.

What are the precautions after filing?

After registering for registration and filing for a long -term residence of inter -provincial and different places, as long as the filing information is not changed or the status of participation is not changed, the record has been valid for a long time, and there is no number of medical treatment. For those who temporarily go out for medical treatment across provinces, the temporary filing period is valid for no less than 6 months. During the validity period, you can take a variety of consultations and enjoy the direct settlement at the medical place. There is no need to take the diagnosis once.

At present, some regions require more than one year after the filing can be canceled or changed. According to the new requirements in the notice, starting from January 1, 2023, the time limit for changing or canceling the filing will not exceed 6 months.

For those who have not had time to apply for filing, the notice clearly clearly reports that the fixed medical institution for medical treatment for medical and place should handle medical expenses directly to the province for the insured person. If the insured is set up for the filing formalities after the disciplinary is settled at their own expense, the medical insurance can be handled by hand -reimbursement in accordance with the regulations.

How to settle in the medical treatment of slow specialties?

The relevant person in charge of the National Medical Insurance Bureau said that at present, more than 200 regions in the country have achieved 5 kinds of clinic related treatment costs such as hypertension, diabetes, malignant tumor chemotherapy, uremia dialysis, and organ transplantation. Cross -provincial settlement.

According to reports, the insured person with a slow special disease qualification of outpatient clinic needs to complete 5 steps to enjoy cross -provincial direct settlement services, including: first step, understanding the qualifications of individuals to enjoy the treatment of slow special diseases for outpatient clinics; Understand the relevant policies of direct settlement of slow special diseases from the insurance site; the third step, select and open the relevant outpatient slow special disease internet -wide network designated medical institutions; the fourth step, actively inform the Internet of -point medical institutions Qualifications; Fifth, settlement of medical insurance electronic vouchers or social security cards as required.

What are the expansion of direct settlement reimbursement expenses for medical treatment?

Aiming at the problems of medical trauma, emergency rescue, and out -of -hospital expenses during the hospital that are concerned about the masses, the notification clearly meets the expenses of non -third -party liability for third -party liabilities stipulated in the regulations of the medical ground management. If you check the treatment or purchase medicines at a fixed -point pharmacy, the relevant expenses are included in this hospitalization expenses cross -provincial direct settlement.

In addition, the notification is allowed to allow long -term residents to enjoy the treatment in two -way landing and insured place.

If the long -term residents' filing period of a long -term provincial and different places, if the validity period of the residents must be returned to the presenter, they can enjoy medical insurance settlement services in the place of insurance. In principle, it is not lower than the treatment level of cross -provincial referrals and referrals.

Relevant policies will be officially implemented from January 1, 2023.

According to Xinhua News Agency

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