Article 41 The basic medical insurance for urban residents implements the management of designated medical institutions, and community health centers are all included in the scope of the first visit of urban residents' medical insurance; insured persons shall go to designated medical institutions. The qualifications of designated medical institutions shall be confirmed by the administrative departments of labor and social security in conjunction with the administrative departments of health.
Article 42 The basic medical insurance for urban residents implements the first consultation and referral system. When a participant goes through the registration procedures, he or she chooses a designated medical institution with hospitalization conditions as the first medical institution for his or her medical treatment. If a participant chooses a community health service center as his or her first hospital, and is referred to a first-level hospital by the community health service center, the participant's personal deductible will be reduced by 5%; when a participant falls ill, he or she will first consult the designated medical institution of his or her own choosing, and if his or her medical condition requires a referral, the first medical institution should promptly handle the referral registration formalities for the patient. Specific management by the labor and social security administrative departments to formulate.
The basic medical insurance fund will not pay for the hospitalization medical expenses incurred without the first medical institution to handle the referral registration procedures. Except for emergency and rescue direct hospitalization.
Article 43 When a participant goes to a designated medical institution to go through hospitalization procedures, he or she shall hand in his or her Zhuzhou City Urban Residents' Basic Medical Insurance Handbook (card) and resident's identity card (ID card or household register), and shall pre-pay his or her personal out-of-pocket expenses. When going through the discharge procedures, the medical expenses that should be borne by the individual shall be settled directly between the individual and the medical institution; the part that should be paid by the basic medical insurance fund for urban residents shall be settled directly between the medical insurance agency and the medical institution.
Article 44 The fixed-point medical institutions shall provide hospitalized participants with a daily list of inpatient medical expenses, and strictly control the use of self-financed drugs, medical consumables, diagnostic and therapeutic items, which must be used to inform and obtain the consent of the patient or his/her relatives in writing in advance. Without the approval of the insured person or his/her relatives, the insured person or his/her relatives have the right to refuse to pay the incurred medical expenses.
Article 45 The fixed-point medical institutions shall conscientiously implement the relevant policies and regulations, standardize the behavior of medical services; under the premise of guaranteeing the basic medical care, to achieve reasonable examination, reasonable medication, reasonable treatment, reasonable charges.
Article 46 The medical expenses of insured persons hospitalized in foreign medical institutions due to referrals as well as family visits, vacations, etc., shall first be borne by the individual 20%, and then settled in accordance with Article 36 and Article 37 of these Measures, with the specific management methods to be formulated separately by the administrative departments of labor and social security.