In 2021, medical insurance for medical treatment in other places will be launched nationwide

Medical insurance has been launched nationwide to provide medical treatment in other places. Starting from February 1, 2020, 27 provinces, municipalities, and autonomous regions across the country have launched cross-provincial settlement pilots for general outpatient fees (excluding chronic disease outpatient fees). Inter-provincial settlement of outpatient expenses relies on the national settlement system. Therefore, as long as we go through the registration procedures for remote hospitalization before remote medical treatment, the direct settlement service for ordinary outpatient expenses will be opened simultaneously. After that, the expenses incurred in remote outpatient clinics can be settled directly with the medical insurance card, and the insured does not need to pay in advance. In addition, for employee medical insurance, the general outpatient payment ratio starts from 50%. In the future, inpatient and outpatient medical care will also be included in the overall account reimbursement, truly helping patients save a lot of real money.

Starting from March 2021, the new national medical insurance drug catalog will be officially implemented. After consultation with drug manufacturers, drug prices were reduced by 50.64%, and 119 kinds of drugs were newly included in the medical insurance catalog this time. In fact, as of the end of 2020, 12 provinces and cities have become pilot cities, and ***27 new pilot cities have been added this time. The pilot provinces and cities include: Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang, Anhui, Chongqing, Yunnan, Sichuan, Guizhou, Tibet, Shanxi, Inner Mongolia, Liaoning, Jilin, Heilongjiang, Fujian, Jiangxi, Shandong, Hubei, Guangxi, Hainan , Shaanxi, Qinghai, Ningxia, Xinjiang, Sichuan, Guizhou, and Tibet have only some overall planning areas.

Three new changes in medical insurance reimbursement for out-of-town medical treatment in 1 and 2021: clarification of hospitalization deductible standards. For employees insured by provincial basic medical insurance who are hospitalized in medical insurance designated medical institutions at the first, second and third levels of medical insurance, the hospitalization deductible standards are respectively They are 500 yuan, 650 yuan and 800 yuan. If an employee is hospitalized multiple times in a medical institution at the same level within a year, and the medical expenses for the last hospitalization exceed the minimum payment standard, the payment will be reduced by 20% according to the minimum payment standard. The minimum amount for the medical institution where you work is not less than 200 yuan.

2. Adjust the reimbursement ratio for non-local inpatients. Insured employees who participate in provincial basic medical insurance shall, after seeking medical treatment in other places in accordance with the relevant provisions of provincial medical insurance, be hospitalized in Beijing, Tianjin and Beijing's top three medical insurance designated medical institutions. Except for medical institutions in Shanghai, Guangzhou, Shenzhen, Beijing and Tianjin that are included in the designated mutual recognition scope of provincial medical insurance, the basic medical insurance hospitalization reimbursement ratio is reduced by 10 percentage points for every payment; "Beijing, Tianjin, Shanghai, Guangzhou and Shenzhen" designated first and second levels The hospitalization reimbursement ratio of designated medical institutions other than medical insurance or "Beijing-Tianjin-Shanghai-Guangzhou-Shenzhen" telemedicine insurance will not be reduced."

3. Adjust the hospitalization reimbursement ratio. If the minimum payment standard of provincial basic medical insurance is higher than the hospitalization threshold, the reimbursement ratio of the medical insurance overall fund will be adjusted to: For employees who are hospitalized in designated medical institutions for the first time, second and third levels, the overall fund payment amount will be: 30,000 yuan, the reimbursement proportions within the policy scope are 91%, 88% and 83%; the overall fund payment is 30,000-70,000 yuan, and the reimbursement proportions within the policy scope are 93%, 90% and 85%; the overall fund payment is 70,000- 200,000 yuan, the reimbursement ratios within the policy scope are 95%, 92% and 87%. In the above-mentioned payment link, the reimbursement ratio for retired employees in medical insurance will be increased by 1 percentage points.

4. It is different between different provinces. It is recommended that medical records be filed according to the place of insurance. If you want to know whether registration is required, you can click "Public Health" and "Public Inquiry" in the navigation bar below through the National Medical Insurance Administration's official account. "Opening of direct settlement coordinating areas for general outpatient expenses across provinces", select the province you want to query and click the query button to query; or you can choose to consult the local medical insurance agency. Insured persons who have registered for inter-provincial direct settlement of medical and hospitalization expenses under basic medical insurance can also open the inter-provincial direct settlement business for general outpatient expenses without the need for separate registration. First, you must pay for your medical treatment upfront. When discharged, ask the medical unit for the original invoice, medication list and medical record. Then bring your ID card, medical insurance card, original receipt, medication order, medical record and other materials to the local medical management center or the medical insurance reimbursement window of a designated medical institution for reimbursement.