The ways to change the designated hospital for medical insurance are as follows:
1. Urban employee medical insurance participants can make changes through the unit on the social insurance online service platform, or the unit can report through the social insurance enterprise version software Check the change of the social insurance agency in the insured area;
2. Urban and rural residents’ medical insurance participants can apply for changes to the social insurance office in the insured area, or individuals can make changes through the social insurance online service platform;
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3. Insured employees who temporarily seek medical treatment in other places for sudden illness outside the city should report to the unit within 3 working days after admission, and the unit shall report to the insured area and county medical department within 5 working days from the date of hospitalization. The insurance agency handles the registration procedures for outpatient clinics;
4. Retirees who are resettled in other places outside the city or employees whose units are assigned to work outside the city for a long time should apply in person and go through the medical insurance agency in the district or county where they are insured. After the institution agrees, 3 designated medical institutions will be identified in the local area for treatment;
5. Those who live in non-insured places in the city or whose units are stationed in non-insured places in the city for long-term work should apply in person. With the approval of the district or county medical insurance agency or the district or county designated agency where the insured is located, a third-level medical institution will be chosen for treatment at the place of residence or work.
Scope of use of medical insurance:
1. Medical insurance can be used for outpatient and inpatient treatment of insured persons in designated medical institutions;
2. Medical insurance is available in some areas For purchasing drugs and medical services in the medical insurance catalog;
3. Medical insurance can be used to pay for public health services such as physical examinations and vaccinations;
4. Medical insurance personal account funds are available Used to pay drug costs at designated retail pharmacies.
To sum up, the ways to change the designated hospital for medical insurance include urban employees changing through their work unit or online platform, urban and rural residents applying individually or changing online, and employees suffering from sudden illness outside the city need to report in time and register for outpatient consultation. , retirees and long-term employees stationed outside the city need to choose a local medical institution after approval, while those who live or work in non-insured places in the city can choose the nearest tertiary medical institution after obtaining consent.
Legal basis:
"Social Insurance Law of the People's Republic of China"
Article 29
Insured Persons The part of the medical expenses that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit. The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.
"Interim Measures for the Administration of Designated Medical Insurance for Medical Institutions"
Article 7
When a medical institution submits an application for designated medical insurance to the coordinating regional agency, it must provide at least the following Materials: (1) Designated medical institution application form; (2) Medical institution practice license or traditional Chinese medicine clinic registration certificate or military medical institution civilian service license copy; (3) Internal management system and financial system corresponding to the medical insurance policy Text; (4) Materials related to medical insurance-related information systems of medical institutions; (5) Predictive analysis reports on the use of medical security funds after inclusion in the designated areas; (6) Other materials provided by provincial medical security administrative departments in accordance with relevant regulations.