Declaration procedure
1. The insured can only seek medical treatment in designated medical institutions in different places after going through the confirmation procedures for medical treatment in different places. The amount of his personal medical account can be withdrawn through any business outlet of the medical insurance card, which is used to support the expenses of outpatient general diseases and the expenses of drug purchase and dispensing in pharmacies. If the insured person is hospitalized (including outpatient specific treatment), he can go to the local designated medical institution for inpatient and outpatient specific treatment, and the medical expenses shall be paid in advance by the individual. Within 1 month from the date of discharge, the insured unit shall apply for reimbursement to the municipal medical insurance center with the following information;
1) copy of the front and back of the medical insurance card;
2) A copy of the confirmed application form for medical treatment in different places;
3) The discharge certificate or medical expenses of specific outpatient items must be accompanied by the diagnosis certificate of a copy of the Mente Application Form approved by the Municipal Medical Insurance Center (except for emergency observation);
4) Detailed list of medical expenses;
5) Official receipt of medical expenses (with the signature of the reimbursement person on the back);
2. When the insured goes to other places (excluding Hong Kong, Macao and Taiwan) to travel, study and visit relatives, he can go to the local public hospital for medical treatment, and the outpatient medical expenses shall be borne by the insured; The expenses incurred by the approved hospitalization (including emergency observation and treatment) shall be paid by the insured in cash, and the unit manager shall apply for sporadic reimbursement to the municipal medical insurance center with the following information: [
1) certificate of the insured unit;
2) Copies of the front and back of the medical insurance card;
3) discharge or diagnosis certificate;
4) Detailed list of medical expenses;
5) Medical expense invoice (followed by the name of the reimburser);
6) copy of hospitalization medical records.
There is no clear legal definition of medical treatment in different places. In social medical insurance coverage, "off-site" generally refers to other areas in China outside the insured's overall planning area, and "seeking medical treatment" refers to the insured's medical treatment behavior, which can be simply defined as the insured's medical treatment behavior outside its overall planning area.
"Off-site medical treatment" is mainly divided into three situations.
First, one-time medical treatment in different places, including emergency treatment during business trips and tourism, leads to the problem that medical expenses cannot be settled in time.
Second, short-term and medium-term mobility. The jobs are not in the insured places for medical treatment in different places, including the personnel stationed in various places of the unit and the local employees of the stationed institutions. Another situation is that the whole unit is in a state of mobility, such as the medical care for employees in the construction industry, and the problems arising are either that they cannot participate in medical insurance or that they have to pay medical expenses in advance.
The third is the medical care of retirees who have been resettled in different places for a long time. Including those whose registered permanent residence is moved from the place of work to the place of resettlement after retirement, and those who rely on their children to move in without registered permanent residence. On the surface, the problem is that the medical settlement is not timely and inconvenient, and the personal burden is heavy. In essence, the medical treatment in a safe place is often better than that in the insured place, and the resettlement personnel feel that the medical treatment is unequal.