First, the premise of cross-city use of Jiangsu medical insurance
First of all, the premise of using the medical insurance card across cities is that the insured's medical insurance relationship has been transferred to the target city or has gone through the formalities of medical treatment in different places. This usually requires the insured to go through the relevant procedures at the medical insurance agency in the original insured place, transfer the medical insurance relationship to the target city, or go to a different place for medical treatment in order to enjoy medical insurance benefits in the target city.
Second, Jiangsu medical insurance cross-city use process
1. When seeking medical treatment in a designated medical institution of medical insurance in the target city, the insured shall present a valid medical insurance card and identity certificate, so that the medical institution can confirm the identity and medical insurance benefits of the insured.
2. Medical institutions will settle expenses according to the insured's medical insurance benefits and medical treatment, and in accordance with relevant regulations. The insured person only needs to pay part of the expenses that the individual should bear, and the rest is paid by the medical insurance fund.
3. If the insured person can't make direct settlement when seeking medical treatment in the target city, he can advance the medical expenses first, and then go back to the original insured place for reimbursement. Relevant medical expense invoices, prescriptions, medical records and other materials should be provided when reimbursing.
Third, matters needing attention
1. When using the medical insurance card across cities, the insured should know the medical insurance policies and regulations of the target city in advance, so as to better enjoy the medical insurance benefits.
2. In the process of medical treatment, the insured shall properly keep the medical insurance card and identity certificate to avoid loss or misappropriation.
3 in case of medical insurance settlement problems or disputes, the insured can consult or complain to the local medical insurance agency for help and solution.
To sum up:
The cross-city use of Jiangsu medical insurance requires the insured to show their valid medical insurance card and identity certificate when seeking medical treatment in the designated medical institutions of medical insurance in the target city after the transfer of medical insurance relationship or medical treatment in different places, and settle the expenses according to relevant regulations. When the insured uses the medical insurance card across cities, they should know the medical insurance policies and regulations of the target city in advance, and properly keep the medical insurance card and identity certificate. If you have any questions or disputes, you can consult or complain to the local medical insurance agency.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 29 provides that:
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
Regulations of Jiangsu Province on Medical Security
Article 16 stipulates:
The administrative department of medical security shall, jointly with relevant departments, establish and improve the five-level medical security handling service system at the provincial, city, county, township and village levels, promote the standardization, standardization and facilitation of medical security services, and realize one-stop service, one window handling and one system settlement of medical security in the whole province.