Improve the direct settlement policy for medical treatment in other places, clarify the direct settlement payment policy for medical expenses in other places, implement the payment scope and relevant regulations of basic medical insurance drugs, medical service items and medical consumables stipulated in the place of medical treatment, and implement the basic provisions of the insurance place.

Relevant policies such as medical insurance fund minimum payment standards, payment ratios, maximum payment limits, and scope of outpatient chronic and special diseases.

Gradually unify the scope of chronic and special diseases in outpatient clinics across the province.

Support retired cadres and other special personnel to directly settle medical bills at designated medical institutions in other places. Each locality can make reasonable allocations based on the basic medical insurance payment scope to ensure that relevant benefits are not reduced.

Improve direct settlement at designated retail pharmacies in other places and support insured persons outside the province to make direct settlement at designated retail pharmacies in other places in Zhejiang.

For out-of-town prescriptions for insured persons in the province who seek medical treatment in other places, such as general outpatient services, outpatient consultations, outpatient services, and hospitalization, the treatment will be settled according to the policy of the insured place; for out-of-town prescriptions that have not been directly settled, they can be returned to the insured place for sporadic processing in accordance with regulations.

to reimburse.

Support insured persons in the province to use their personal account balances to make direct settlements at designated retail pharmacies in other places in accordance with regulations.

Support long-term residents in other places to enjoy medical insurance settlement services in both directions. Long-term residents in other places can seek medical settlement in the place of registration and implement the treatment policies and standards of the insured place; if they really need to return to the insured place for medical treatment within the validity period of the registration, they can enjoy medical insurance settlement services in the insured place.

, the treatment will be implemented in accordance with the policies and regulations of the insured area, and in principle it will not be lower than the treatment level for referrals to other hospitals in the insured area; if the transfer regulations are met and filed for medical treatment outside the insured area, the treatment policies and standards for referrals to other hospitals will be implemented.

Standardize the reimbursement and treatment policy for people who temporarily go out for medical treatment. People who temporarily go out for medical treatment in the province will be settled at the registration place. The medical insurance treatment policy can be lower than the reimbursement level of medical institutions of the same level in the insured place.

In principle, the fund payment ratio for emergency rescue personnel in other places will not decrease; the fund payment ratio for non-local referral personnel (including deemed referral personnel) will not decrease by more than 10 percentage points (if individual first-pay payment is implemented, the individual first-pay payment ratio will not exceed 10 percentage points).

10 percentage points), and the decrease in the fund payment ratio for non-emergency and non-referred temporary medical treatment shall not exceed 20 percentage points (if individual self-payment is implemented, the individual payment ratio shall not exceed 20 percentage points).

Support direct settlement of medical expenses for injuries in other places without third-party liability. With the patient's commitment and compliance with the management regulations of the place of medical treatment, trauma medical expenses without third-party liability can be included in the scope of direct settlement of medical treatment in other places, and corresponding medical insurance treatment policies will be implemented.

The agency responsible for the medical treatment will include relevant expenses into the scope of verification.

Optimize the management of direct settlement and filing for medical treatment in other places and standardize the categories of people seeking medical treatment in other places. People seeking medical treatment in other places are divided into long-term residents in other places and people who temporarily go out for medical treatment.

People who live in other places for a long time, including retired people who are resettled in other places, people who live in other places for a long time, permanent staff in other places and other people who work, live and live outside the insured place for a long time; People who temporarily go out to seek medical treatment, including those who are referred to medical treatment in other places, due to work

, emergency rescue personnel who travel to other places due to travel and other reasons, and other personnel who temporarily go out for medical treatment across the coordinating area.

Further optimize the registration process for medical treatment in other places. The registration process for temporary out-of-town medical treatment within the province has been cancelled. Insured persons can seek medical treatment and purchase medicines at designated medical institutions in other places in the province without registration according to regulations and pay directly.

When insured persons seek medical treatment in other places across provinces, they can go through the registration procedures for medical treatment in other places through online and offline channels such as the National Medical Insurance Service Platform APP.

Encourage qualified prefectures and cities to provide insured persons with self-service registration services that can be processed immediately and take effect immediately.

Standardize the validity period of registration for medical treatment in other places. After long-term residents in other places register and file, the registration can be valid for a long time; the registration of temporary out-of-town medical treatment personnel is implemented as "one registration, valid for 12 months". After the validity period expires, the same disease must continue to be treated at the same place.

For treatment or review, the filing procedures can be simplified.

Within the validity period of the registration, you can visit the place of medical treatment multiple times and enjoy direct settlement services for medical treatment in other places. If you have gone through the admission procedures within the validity period of the registration and are discharged after the validity period, the overdue period will be deemed to be within the valid registration period.