“Urban and rural residents can also be reimbursed for general outpatient visits at township health centers and community service centers.” The reporter asked the Municipal Medical Insurance Bureau to learn about the relevant situation. The relevant person in charge of the bureau said that urban and rural residents insured patients When you go to the town health center or neighborhood community health service center for treatment, you only need to bring your ID card or social security card to enjoy the general outpatient treatment. You only need to pay the personal part when paying for outpatient medical expenses.

General outpatient co-ordination is a form of medical insurance benefit, which means that the ordinary out-patient expenses of the insured persons are included in the reimbursement, and the basic medical insurance co-ordination fund and the individual patient jointly bear the general out-patient expenses. Compensation fees will be centralized and paid uniformly by the outpatient coordinating fund to compensate for outpatient medical expenses.

According to reports, insured persons can use their ID cards or social security cards to receive outpatient treatment at the town health center or neighborhood community health service center. 50% of medical expenses will be reimbursed and 70% of general medical expenses will be reimbursed. There is no limit to the number of medical visits per year, and there is no threshold or cap for outpatient reimbursement. Items exceeding RMB 100 for a single examination will not be reimbursed.

Urban and rural residents’ medical insurance participants who live and work across districts in the city should go to the town health center (street community health service center) where their household registration is located with their ID cards or social security cards to fill out the "Yangjiang City Urban and Rural Residents Medical Insurance General" Outpatient Clinic Referral Form for Living (Working) in Other Places in the City", go through the general outpatient clinic transfer procedures, and after being stamped and confirmed by the town health center (street community health service center) where the household registration is located, go to the town health center (street community health service center) where you currently live and work. Community Health Service Center) to go through the transfer procedures, and go to the medical insurance agency where they currently live and work to go through the transfer registration procedures. Urban and rural residents who live and work in other places can go to the town health center (street community) where they currently live or work. Health Service Center) and designated village health stations within their jurisdiction enjoy general outpatient treatment reimbursement.

If the insured person lives or works outside the city, he or she can bring his or her ID card or social security card, "Application Form for Medical Treatment for Settlement (Work) in Other Places", medical invoice (original) and expense list (original) back to the insurance company. The medical insurance agency in the insured area reimburses general outpatient treatment, with a total annual reimbursement of 50 yuan.

The information required for outpatient reimbursement is as follows:

1. Outpatient invoice

2. Outpatient prescription (invoice issued by the pharmacy). Western medicine does not require a prescription, while traditional Chinese medicine requires a prescription. All inspection and laboratory bills must be accompanied by a report form, and treatment fees will not be reimbursed)

3. Copy of the medical insurance book (the first and second pages are copied onto an A4 paper).

Legal Basis

"Basic Medical Care and Health Promotion Law of the People's Republic of China"

Article 30: The state promotes the implementation of grading of basic medical services The diagnosis and treatment system guides non-emergency patients to go to primary medical and health institutions first, implements the first-diagnosis responsibility system and the referral review responsibility system, and gradually establishes a mechanism for primary-level first diagnosis, two-way referral, emergency and chronic treatment, and linkage between the upper and lower levels, and integrates it with the basic The medical insurance system is connected.