Liaoning issued a new regulation ** card different places to medical settlement "with rules to follow"

Employees who want to live in different places after retiring may apply for local medical insurance cards at 2 to 3 designated local hospitals for reimbursement; long-term foreign staff can also send the account funds on the medical insurance card directly to them to facilitate their medical purchases. medicine. On August 16, the website of the Liaoning Provincial Office of Human Resources and Social Security issued the “Guiding Opinions on Basic Medical Insurance Out-of-home Medical Management Services”, and detailed regulations were provided for all types of situations in which the basic medical insurance for urban workers of different provinces visited medical facilities. .

According to reports, various provinces and cities across the country have differences in terms of medical insurance premium rates, reimbursement starting lines, top line, payment ratios, reimbursement categories, and drug coverage. The "Opinions" issued by our province specifically set up different methods for dealing with medical problems in different places. It is finally possible for the doctors in different places to "have rules to follow".

For the short-term business trip participants, the medical expenses incurred in emergency outbreaks in other places and emergency treatment in the local area (hereinafter referred to as the emergency department), and the emergency medical bills and relevant medical and treatment data, shall be reviewed and reimbursed by the participating medical insurance agencies in accordance with relevant regulations. . In other words, advance advancement and reimbursement afterwards.

If local medical conditions limit the need for referral, experts from the highest local hospital shall consult and submit referral opinions. After the approval of the chief dean and report to the local medical insurance agency for examination and approval, the referral of the medical expenses incurred in the other place will be settled. In accordance with the relevant provisions of the participating places. In areas where conditions permit, the medical insurance agency may negotiate with a regional medical insurance agency with a more concentrated referral to enter into an agreement entrusting him to manage the management of the referral staff or review the expenses.

If it is a long-term (more than 6 months) work in the domestic over-consolidation area, after the application is approved, 2 to 3 different levels of hospitals can be selected as the designated medical institutions in the workplace. Measures for the settlement of medical expenses incurred by the insured employees at designated medical institutions in the work place shall be formulated by each of the coordinating regions.

After retiring, they intend to settle for a long period of time (more than one year) in a different place, and obtain a long-term residence certificate of the public security department at or above the county level where they live, and may choose it at the place of settlement or place of residence upon the approval of the medical insurance agency of the person applying for and participating in the insurance. To 3 different levels of hospitals as remote designated hospitals. The method of settlement of medical expenses incurred at the place of residence shall be formulated by each of the co-ordinating regions.

In the event of a short-term business trip, such as work, study, or visit to the country (outside of the country), the medical insurance co-ordinating fund will not pay for the medical expenses incurred as a result of the illness. If it is outside the country (outside) for a long period of time (more than 6 months) and continuous payment, according to the local hospitalization personnel average hospital stay in the same period, in the unified fund will be part of the expenses paid to their units, with The compensation for medical expenses of personnel sent abroad (outside).

In addition, the "Opinions" also proposed that, in order to facilitate the majority of insured persons, after the occurrence of medical expenses, the participating organizations can use postal reimbursement, set up charge d'affaires in the areas where the insured personnel are concentrated, and entrust the management of medical sites. Agency services, such as reimbursement, provide services. The coordinating regions at all levels will also take measures to facilitate the settlement of medical expenses for various types of medical personnel participating in medical treatment, reduce personal advancement of medical expenses, and shorten the waiting time for reimbursement and settlement.