1. According to the local medical insurance regulations, people who go to other places for medical treatment should first go through the registration procedures for medical treatment in other places at the medical insurance agency in the insured place, and the medical expenses incurred by medical treatment in other places should be paid in advance by themselves. After the medical treatment, you should go through the reimbursement procedures with the relevant bills to the medical insurance agency in the insured area.
2. If the medical insurance network settlement is realized between the insured place and the medical treatment place, the personnel who need medical treatment in different places can go through the medical treatment procedures in different places according to the relevant provisions of local medical insurance, and then go to the medical treatment place to brush the medical insurance card for medical treatment, and directly settle the medical expenses without paying the medical expenses in advance.
3. The insured place and the medical place where the insured person wants to go have established a cooperative relationship of medical insurance reimbursement, so that the insured person can directly entrust the medical insurance agency in the medical place to handle the medical expenses reimbursement in the medical place as long as he has gone through the relevant registration and filing procedures in accordance with the regulations.
Legal basis:
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
Derivative problem:
What is the reimbursement process of hospitalization medical insurance?
First, under normal circumstances, when you need to be hospitalized due to illness, you can go to the designated hospital with the medical insurance card and medical records, and you can use the medical insurance card for settlement. That is to say, some of them are paid by themselves at their own expense, and some medical insurance centers and hospitals reimburse and settle accounts.
Second, if you transfer from a designated hospital to a secondary or tertiary hospital, the medical insurance card will be settled, as above.
Three, critically ill, hospitalized in non designated hospitals, within 5 days to the city medical insurance center for emergency rescue disease identification, identified as emergency rescue disease, you can use the medical insurance card in the rescue hospital settlement.
Four, transferred to other places for treatment, with the consent of the hospital and medical insurance center, for referral procedures. The expenses incurred in the field shall be settled by the individual at his own expense, and after the diagnosis and treatment, the community labor security workstation shall prepare the materials for reimbursement.
Five, medical insurance reimbursement is calculated in proportion, generally ranging from 70%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors.