1. Relocation of retirees in different places: resident ID card, social security card, and identification materials for relocation;
2. Long-term residents in different places: resident ID card, social security card and proof of long-term residence;
3. Resident in different places: resident ID card, social security card, and proof of work in different places;
4. Referral personnel in different places: resident ID card, social security card, and referral certification materials issued by designated medical institutions with referral qualifications;
5. Other temporary medical personnel, resident identity cards and social security cards.
Note: in addition to the above materials, the original ID card of the agent is required for entrusting others to act as an agent.
The records of medical treatment in different places are as follows:
1. Resettlement of retirees in different places: refers to those who have settled in different places after retirement and moved into their place of residence;
2. Long-term residents in different places: refers to people who live in different places and meet the requirements of the insured place;
3. Resident in different places: refers to the personnel who are sent by the employer to work in different places and meet the conditions of the insured place;
4. Referral personnel from different places: refers to those who have been diagnosed by hospitals at or above the county level with referral qualifications and cannot be diagnosed due to limited medical technology and equipment in this city, and need to be transferred to other hospitals for treatment;
5. Other temporary medical personnel who go out for medical treatment: other temporary medical personnel who have not gone through the referral procedures according to the provisions of the insured area among the insured persons of basic medical insurance.
To sum up, the insured who directly handle the settlement of medical treatment in different provinces or temporarily go out for medical treatment in different provinces can apply.
Legal basis:
Article 2 of the Notice on Further Improving the Direct Settlement of Medical Treatment in Different Provinces of Basic Medical Insurance
Improve the policy of direct settlement of medical treatment across provinces and different places
(a) unified hospitalization, general outpatient and outpatient chronic diseases and special diseases across the province direct settlement fund payment policy. Inter-provincial direct settlement of hospitalization, general outpatient service and outpatient service for chronic diseases and special diseases shall, in principle, be implemented according to the payment scope and relevant regulations (such as basic medical insurance drugs, medical service items, medical consumables, etc.) stipulated by the insured place, and the relevant policies such as the minimum payment standard, payment ratio, maximum payment limit and outpatient disease range of the basic medical insurance fund shall be implemented.
(2) Defining the scope of medical records in different places. Insured persons who live in different provinces for a long time or temporarily go out for medical treatment can enjoy the direct settlement service for medical treatment in different places after filing medical treatment in different places. Among them, inter-provincial permanent residents include retirees resettled in different places, permanent residents in different places, permanent residents in different places and other personnel who have worked, lived and lived outside the insured provinces, autonomous regions and municipalities directly under the Central Government (hereinafter referred to as provinces) for a long time; Inter-provincial temporary medical personnel include those who have been referred for medical treatment in different places, emergency personnel in different places due to work, tourism and other reasons, and other inter-provincial temporary medical personnel.
(three) standardize the validity of medical records in different places. Those who live in different provinces for a long time shall register for the record, and the record shall be valid for a long time; The insured place can be set to change or cancel the filing period, in principle, not more than 6 months. In principle, the validity period of inter-provincial temporary medical personnel is not less than 6 months. During the validity period, you can see a doctor many times in a medical place and enjoy the direct settlement service for medical treatment in different provinces.
(4) Allow trauma insured persons who have to reissue medical records in different places and have no third-party responsibility to enjoy direct settlement services for medical treatment across provinces. If the insured goes through the medical record in different places before the inter-provincial discharge settlement, the designated medical institution connected with the medical place shall handle the inter-provincial direct settlement of medical expenses for the insured. Insured persons who go abroad for medical treatment at their own expense may apply for manual reimbursement of medical insurance according to the provisions of the insured place after discharge. At the same time, trauma expenses without third-party liability that meet the requirements of medical place management can be included in the scope of direct settlement of medical treatment in different provinces, and medical place agencies should include related expenses in the scope of verification.
(five) residents who support long-term inter-provincial can enjoy medical insurance benefits at the same time at the place of filing and insurance. When inter-provincial permanent residents seek medical treatment and settlement at the filing place, the Qifubiaozhun, payment ratio and maximum payment limit of the basic medical insurance fund shall, in principle, implement the local medical treatment standards stipulated by the insured place; If it is really necessary to go back to the insured place for medical treatment within the validity period of the record, you can enjoy the medical insurance settlement service in the insured place, which is not lower than the inter-provincial referral treatment level of the insured place in principle. Among them, if the insured person goes through the filing procedures for inter-provincial permanent residents in the form of personal commitment, after completing the relevant filing materials, he should fulfill his promise and enjoy medical insurance benefits at the filing place and the insured place. Inter-provincial permanent residents who meet the conditions for going abroad for medical treatment shall implement the inter-provincial referral and transfer treatment policy in the insured areas.
(6) Reasonably determine the inter-provincial reimbursement policy for temporary medical personnel. According to the level of economic and social development, people's health needs, the support capacity of medical insurance fund and the requirements of graded diagnosis and treatment, all overall planning areas should reasonably set up a policy of direct settlement and reimbursement for temporary medical personnel going out across provinces. Provincial temporary medical personnel can be lower than the reimbursement level of medical institutions at the same level in the insured area. In principle, the proportion of payment for off-site referral personnel and off-site emergency rescue personnel shall not decrease by more than 10 percentage point, and the proportion of payment for other non-emergency referral inter-provincial temporary medical personnel shall not decrease by more than 20 percentage points. Strengthen the coordination between the settlement policy of medical treatment in different places and the grading diagnosis and treatment system, reasonably determine the differences in reimbursement levels of medical personnel in different levels of medical institutions, and guide the insured to seek medical treatment in an orderly manner.