Why is it so difficult to seek medical treatment in other places, and is it considered to be remote

How to apply for remote medical treatment?

The operation method of remote medical treatment in Yongzhou City, Hunan Province is as follows:

What is out-of-town medical treatment?

The so-called remote medical treatment means that I live for a long time outside the place of household registration or medical insurance, and hope to see a doctor in a different place, and whether the hospitalization can be reimbursed.

I am a native of Lengshuitan District, Yongzhou City, Hunan Province, and live in Haoyu Stone, Huadu District, Guangzhou City. If you want to apply for medical treatment in other places, the designated hospitals are two hospitals: "Hospital of Integrated Traditional Chinese and Western Medicine" and "People's Hospital".

Since I have already handled remote medical treatment in 2006, and the designated hospitals are two hospitals: "Hospital of Integrated Traditional Chinese and Western Medicine" and "People's Hospital". (The specific method is: handle it from the Yongzhou Social Security Bureau, the social security bureau where the household registration is located, file it, fill in a form for medical treatment in other places, and fill in the relevant information and information.)

Then get the two hospitals in Huadu District, Guangzhou City, where they are temporarily resident, and seal them, and then take them back to the Yongzhou Social Security Bureau where the household registration is located to seal them, and the matter is done. Keep a copy of the original in your possession in case you need to be reimbursed for hospitalization in the future. ）

In addition, when it comes to the alternation of the old medical insurance card and the social health insurance card (new card) that was replaced 2 years ago, in order for your new card to be used in other places, you need to do the following steps:

1) Activate the normal functions of the new card issuing bank on the spot.

2) I (of course, it can also be replaced) take the old and new cards to any local designated pharmacy where you can swipe the medical insurance card, and activate the remote medical treatment function (also called the financial function) of the new card. Enter the password and use the purchase medicine. Activate this new card.

3) After the new card is activated, take it to the inpatient department of the designated hospital and check how to use it.

Third, you must pay attention to one thing, within 3 days after you go through the hospitalization procedures, you must fax a copy of your ID card, hospitalization form, and fixed-point stamp** to the social security bureau where your household registration is located, so as to inform them that you are going to be hospitalized and need to be reimbursed in another place. They will enter your information before it can be used normally.

Legal Analysis: Cross-city Calculation of Remote Medical Treatment.

The procedures that need to be handled for medical treatment in other places are as follows:

1. Insured persons who live in other places for a long time can fill in the application form for medical treatment in other places, choose 1-5 designated hospitals in their place of residence, and pay the inpatient medical expenses incurred in the selected designated hospitals according to the level of the hospital, and do not reduce the reimbursement ratio.

2. Steps to go through the procedures for medical treatment in other places.

1) Fill in the "Record Form for Medical Treatment in Designated Medical Institutions for Insured Persons Resident Abroad and Living in Other Places";

2) Written application (briefly stating the reason for long-term residence in a different place);

3) Proof of long-term residence in a different place (a copy of the household registration booklet, a copy of the temporary residence permit, and one of the certificates from the local police station or community neighborhood committee or work unit of the long-term residence).

3. Medical expenses incurred in other places without going through the procedures for medical treatment in other places will not be paid by medical insurance** (except for emergency treatment).

4. For the insured persons who have gone through the procedures for medical treatment in other places, the inpatient medical expenses incurred in the designated medical institutions in the overall planning area shall be reimbursed in accordance with the relevant provisions of medical treatment in other places.

Legal basis: "Interim Measures for the Administration of Medical Security Designation in Medical Institutions" Article 5 The following medical institutions that have obtained the practice license of medical institutions or the record certificate of traditional Chinese medicine clinics, as well as military medical institutions approved by the competent military departments and have the qualifications to serve the people, may apply for medical insurance designation:

1) General hospitals, traditional Chinese medicine hospitals, integrated traditional Chinese and Western medicine hospitals, ethnic medicine hospitals, specialized hospitals, and ** hospitals;

2) Specialized disease prevention and treatment institutions (institutes, stations), maternal and child health care hospitals;

3) Community health service centers (stations), central health centers, township health centers, neighborhood health centers, outpatient departments, clinics, health centers (stations), and village clinics (offices);

4) Independently set up emergency centers;

5) Palliative care centers, hemodialysis centers, and nursing homes;

6) Medical institutions within pension institutions.

Internet hospitals may rely on their physical medical institutions to apply for the signing of supplementary agreements, and the relevant expenses incurred by the medical services provided by them that meet the scope of medical insurance payment shall be settled by the coordinating regional agency and the entity medical institutions on which it relies in accordance with regulations.

Medical treatment in other places refers to the medical treatment behavior of medical insurance personnel outside the insurance co-ordination area.

In the scope of social medical insurance, "non-local" generally refers to other domestic regions other than the overall area where the insured is insured, and remote medical insurance can be simply defined as the medical treatment behavior of the insured outside the overall area of the insured. In recent years, Guangdong, Shanxi, Hubei, Liaoning and other provinces have realized the settlement of medical insurance in different places.

"Remote medical insurance" is mainly divided into three situations.

The first is one-time medical treatment in other places, including acute illnesses during business trips and travels** and patients who voluntarily transfer to other places to sell doctors, and the problem is that medical expenses cannot be settled in time.

The second is the short- and medium-term mobility, the job is not in the place of non-local medical treatment, including the unit in various types of sail to the station, the stationed agency in the local employment personnel, there is also a situation that the whole unit is in a state of mobility, such as the construction industry and other workers for medical treatment, the problem is either that you can not participate in medical insurance, to pay medical expenses in advance.

The third is the medical treatment of retirees who have been resettled in other places for a long time. Including those who have moved their hukou from their place of work to the place of resettlement after retirement, as well as those who have migrated without hukou due to their children, the problems arising from this are ostensibly that the settlement of medical treatment is not timely and inconvenient, and the personal burden is heavy, but in fact, the medical treatment in the resettlement place is often better than that in the insured place, and the resettlement personnel feel that the medical treatment is unequal.

The insured person is in other regions within the territory outside the overall planning area of the city (excluding Hong Kong, Macao and Taiwan).

hereinafter referred to as "remote medical treatment".

Specifically, it includes: 1) Long-term medical treatment in other places: the insured person has lived, worked or studied in the same place in China for more than 6 months, and selected local medical insurance designated medical institutions in other places due to illness.

Hereinafter referred to as remote medical institutions).

2) Non-local emergency treatment: The insured person is hospitalized in an emergency department or kept for emergency observation in a non-local state failure medical institution in China.

3) Students seeking medical treatment in other places: Students who are on vacation or suspended due to illness should return to the place of household registration.

or seek medical treatment in a medical institution in a different place during the study or internship at a branch school in a different place.

4) Referral from other places: Insured patients in this city are transferred to other places after approval.

5) Other situations of medical treatment in different places as provided for in the policy.

Non-local medical treatment refers to the medical treatment behavior of the insured person outside the insurance co-ordination area. The place where the personnel are insured and the place where the medical expenses occur is not the same area as Liangjujube.

In the scope of social medical insurance, "non-local" generally refers to other domestic regions other than the overall area where the insured is insured, and "medical treatment" refers to the medical treatment behavior of the insured.

1. I have already gone through the filing for medical treatment in other places, do I need to go through other procedures again before being hospitalized in other places in order to enjoy the direct settlement treatment? Answer: If the insured person has gone through the filing for medical treatment in another place, he or she can settle the hospitalization and directly settle the medical expenses in the remote network settlement medical institution where the record is located without going through other procedures within the validity period.

2. How to reimburse the general outpatient medical expenses incurred in other places if the medical treatment has been filed in other places? Answer: The insured person who has applied for the record of remote medical treatment can only enjoy the outpatient treatment in other places (including the outpatient treatment that occurs in the same diagnosis and treatment process as the current hospitalization) and specific outpatient diseases (hereinafter referred to as:

For ordinary outpatient expenses incurred in other places, Guangzhou Municipal Medical Insurance will not envy or reimburse. Note: Employees who have gone through the record of long-term medical treatment in other places shall be based on the monthly payment base of their own employee social medical insurance, of which the average monthly salary of on-the-job employees in the city in the previous year shall be used as the base, and the standard of 2% per person per month (up to 300 yuan) shall be paid by the co-ordination ** for the overall treatment of general outpatient services.

3.What materials should employees who apply for long-term medical treatment in other places to withdraw the outpatient lump sum payment? A:

Employees who have gone through the record for long-term medical treatment in other places can bring their valid identity documents and social medical insurance certificates (social security cards and medical insurance cards with medical insurance functions) to the designated business outlets of the corresponding card-issuing banks to go through the withdrawal procedures (the specific business handling outlets can consult the corresponding card-issuing bank for the address of the outlets). If you encounter any problems, you can consult and reflect to the medical insurance sub-centers in our city. 4. After filing for medical treatment in other places, can the insured continue to seek medical treatment in Guangzhou?

Answer: After the treatment of remote medical treatment takes effect, the insured persons who have handled the temporary filing of remote medical treatment can still enjoy the medical insurance treatment of hospitalization, gate and general outpatient in designated medical institutions in the city; Insured persons who have applied for long-term medical treatment in other places will no longer continue to enjoy the treatment of hospitalization and special treatment in the city, and will no longer enjoy the general outpatient medical insurance treatment in the city from the next month after the completion of the application. 5. If I have gone through the record for long-term medical treatment in other places and temporarily return to the designated medical institutions in the Guangzhou Medical Insurance Co-ordination Zone for medical treatment, can I enjoy the medical insurance treatment?

Answer: Insured persons who have gone through the long-term record for medical treatment in other places, temporarily return to Guangzhou for medical treatment, and stay in the designated medical institutions for emergency observation or emergency hospitalization, can contact the Guangzhou Medical Insurance Sub-center through the medical institution to handle the relevant treatment opening procedures, and the medical expenses that meet the requirements can be directly billed and settled by Guangzhou Medical Insurance. Other medical expenses will not be paid by Guangzhou Medical Insurance**.

6. If the long-term non-local medical treatment filing is cancelled, when can the medical treatment in Guangzhou be resumed? Answer: After the long-term remote medical treatment filing personnel cancel the filing, they can record and settle the hospitalization and gate expenses at the designated medical institutions in Guangzhou on the same day.

From the following month, the general outpatient medical expenses can be booked and settled at selected medical institutions in Guangzhou. Among them, for employee insured, the allocation of general outpatient co-ordination lump sum fees will be cancelled at the same time.

Promoting the direct settlement of basic medical expenses across provinces and places can effectively promote the construction of people's livelihood and well-being, and realize the standardized and standardized development of the management of the medical security system.

1. Inter-provincial settlement standards and process convergence are difficult to close.

There are great differences in medical insurance policies in different places, there are certain differences in the scope and proportion of reimbursement in different places, there is no unified medical insurance system in the country, and there are certain difficulties in cross-provincial reconstruction and docking. Li Moumou of Hedong Village, Fuzhuang Town, has been working abroad all the year round, and has carried out medical insurance in the local area a few years ago, and when he was sick in the field last year, he suddenly found that there are differences in the scope of medical insurance reimbursement between the construction site and the insured place, and the reimbursement policies are not the same, for example, in the local area, as long as the medical expenses belong to the "three catalogs", they can be reimbursed, while at the work site, some medical institutions cannot reimburse for minor diseases such as colds, coughs, and diarrhea.

Second, the medical insurance reimbursement procedure is cumbersome, and the scope of inter-provincial settlement services is small.

First, the reimbursement of medical insurance in different places is "running and breaking legs", with multiple supporting materials and multiple handling audits, and the reimbursement procedures are cumbersome and cumbersome. Second, the scope of direct settlement services for cross-provincial and non-local medical treatment is small, for example, the cross-provincial settlement of some outpatient chronic diseases cannot be reimbursed in other places, and patients are often trapped in paying high medical expenses in advance. Liu's family in Fuzhuang Community, Fuzhuang Town, because of the little granddaughter's perennial treatment abroad, medical insurance reimbursement has become the hope of the whole family, Liu sighed, each reimbursement has to run multiple departments, take multiple materials, and stamp multiple seals in order to successfully reimburse, hoping to reduce the reimbursement procedures in different places and expand the scope of cross-provincial settlement.

3. There are few designated medical institutions for direct settlement in different places.

Most of the cross-provincial medical treatment is transferred to high-quality hospitals in Beijing, Shanghai and Guangzhou, and for people in rural areas, there are not many opportunities to contact big cities, and it is difficult for migrant workers to see a doctor in other places.

1. The patient himself or his family members should go to the local medical insurance department for filing, and some places have opened the ** filing business. When filing for the record, you must ask whether you can go to the hospital of your choice for medical treatment and what information is required for reimbursement.

2. Patients must bring their ID cards and medical insurance cards when seeking medical treatment.

3. Under normal circumstances, patients should try their best to seek medical treatment in designated medical institutions with national networking, so that they can directly reimburse medical expenses.

Article 29 of the Social Insurance Law of the insured persons shall be paid by the basic medical insurance** of the part and limb of the department, by the social insurance agency and the medical institutions, drug business units directly settled.

The administrative departments of social insurance and health shall establish a system for calculating the medical expenses for medical treatment in other places, so as to facilitate the insured persons to enjoy basic medical insurance benefits.