Urban and rural medical insurance allows for medical treatment in other places, but certain regulations and procedures need to be followed. When seeking medical treatment in other places, insured persons can enjoy the benefits of medical insurance, but they need to meet certain conditions and go through corresponding procedures.

1. Understand the policies for medical treatment in other places

The urban and rural medical insurance policies in different regions may be different. Therefore, before seeking medical treatment in other places, insured persons need to understand the medical insurance policies of the destination. Including reimbursement scope, reimbursement ratio, reimbursement limit, etc. This helps insured persons better plan their medical itinerary and cost budget.

2. Go through registration procedures for medical treatment in other places

Before seeking medical treatment in other places, insured persons need to go to the medical insurance agency or online service platform in the insured place to complete the registration procedures for medical treatment in other places. When filing, you need to provide personal identity certificate, medical insurance card and other relevant materials, and fill in the off-site medical filing application form. After successful registration, insured persons can enjoy medical insurance benefits when seeking medical treatment in other places.

3. Choose designated medical institutions for medical treatment

When seeking medical treatment in other places, insured persons should choose local designated medical institutions for medical treatment. Designated medical institutions are medical institutions that have signed service agreements with medical insurance agencies. Insured persons can enjoy reimbursement benefits from medical insurance when seeking medical treatment in these institutions. If you choose to seek treatment at a non-designated medical institution, the proportion and scope of reimbursement may be affected.

4. Keep relevant certificates and bills

During the process of medical treatment in other places, insured persons need to properly keep all medical certificates and bills, including diagnosis certificates, prescription orders, and medical expense invoices. wait. These vouchers and bills are important basis for subsequent reimbursement. If lost or damaged, it may affect the smooth progress of reimbursement.

5. Handle medical expense reimbursement procedures

After receiving medical treatment, insured persons need to go through medical expense reimbursement procedures in accordance with the regulations of the insured place. Relevant vouchers and bills usually need to be submitted to the medical insurance agency in the insured place for review and reimbursement. The reimbursement amount will be calculated and paid in accordance with the policies of the insured place.

In summary:

Urban and rural medical insurance allows for medical treatment in other places, but the insured needs to understand the policies for medical treatment in other places, go through the registration procedures for medical treatment in other places, choose designated medical institutions for medical treatment, and retain relevant information Vouchers and bills, and go through the medical expense reimbursement procedures after the medical treatment. During the application process, insured persons need to comply with relevant regulations and procedures to ensure that they can smoothly enjoy medical insurance benefits.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 30 stipulates:

The following medical treatments Expenses are not included in the payment scope of the basic medical insurance fund:

(1) Should be paid from the work-related injury insurance fund;

(2) Should be borne by a third party;

(3) The medical expenses should be borne by the public health department;

(4) Medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first. After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.

"Notice on Further Improving the Direct Settlement of Medical Expenses for Medical Treatment in Different Places Across Provinces for Basic Medical Insurance"

Article 4 stipulates:

Long-term settlement of medical expenses in different places across provinces Insured persons who live or temporarily go out for medical treatment across provinces can enjoy direct settlement services for medical treatment in other places across provinces after registering for medical treatment in other places. Among them, long-term residents who live in other places across provinces include retirees resettled in other places, long-term residents in other places, permanent staff in other places and other people who work, live and live outside the insured province for a long time; people who temporarily go out for medical treatment across provinces include those who are referred for medical treatment in other places. , emergency rescue personnel who travel to other places due to work, travel and other reasons, and other personnel who temporarily go out for medical treatment across provinces.