I, who need to record the foreign medical
(a) the foreign settlement of retirees: refers to the retirement in the foreign settlement and household registration moved to the settlement of the person.
(2) Long-term residents of other places: those who live in other places and meet the requirements of the insured places.
(3) Resident workers in a different place: those who are sent by their employers to work in a different place and meet the requirements of the place of insurance.
The above three categories of personnel referred to as "out-of-home personnel", the procedures will be suspended at the same time as the Suzhou Social Security _ Citizen Card in the participating places of the card settlement function, for the record 60 days before applying for the record to cancel the procedures.
(4) Referral from other places: refers to those who need to be referred to overseas hospitals for treatment because they suffer from difficult and serious diseases that cannot be diagnosed and treated under the conditions of medical technologies and equipments in the city, and are diagnosed by hospitals with referral qualifications at or above the city or county level. Referrals need to be first to the city's medical institutions with referral qualifications for referral procedures, the record is valid for one year.
Two channels for filing medical records in other places
(1) WeChat public number of "Suzhou Medical Insurance".
(2) The national small program for filing for medical treatment in a different place (inter-provincial medical treatment filing).
(3) Medical (social) insurance agency counter.
Three, the process of filing for medical treatment in a different place
(a) first record. First through the "meet" or "do not meet" channel for the record.
(2) Choose the place of medical treatment. The medical treatment in a different place is not the same as "national roaming", and the place of medical treatment should be selected when filing.
(3) Holding the card for medical treatment. In the medical institutions that have opened the network settlement of medical treatment in other places, the provincial standard social security card is used to directly settle the medical insurance expenses in accordance with the provisions of the card.
Fourth, the treatment of medical treatment in other places
Direct settlement of medical treatment in other places carries out the medical process and service norms of medical institutions in the place of medical treatment. The settlement of intra-provincial medical treatment is in accordance with the "catalog of the insured place and the policy of the insured place". The settlement of cross-provincial medical settlement in accordance with the "directory of the place of medical treatment, the policy of the place of insurance" settlement, direct settlement of medical treatment in a different place may be differences in costs and treatment, which is a normal phenomenon.
Suzhou has applied for the record of outpatient medical treatment, such as eligible to apply for outpatient treatment of specific items, in order to avoid treatment affected, after diagnosis, should contact as soon as possible to participate in the local medical (social) insurance agency to apply for the relevant procedures in accordance with the provisions of the law.
V. Querying medical institutions for cross-provincial hospitalization network settlement
1. National health insurance service platform: you can query medical institutions that have opened cross-provincial hospitalization network settlement.
2. The official website of Jiangsu Provincial Medical Protection Bureau: you can inquire about the medical institutions in Jiangsu province that have opened inter-provincial hospitalization, Yangtze River Delta outpatient services and intra-provincial cross-district medical settlement network.
Legal basis
Article 28 of the Social Insurance Law of the People's Republic of China*** and the State of China: Medical expenses that are in accordance with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29 of the Social Insurance Law of the People's Republic of China
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.