Using the medical insurance card to see a doctor in other hospitals during hospitalization may have the following effects:
1。 Payment method: If your medical insurance card has been used in inpatient medical institutions, you may need to pay at your own expense or in other ways when you see a doctor in outpatient medical institutions. Because the inpatient medical institution may reserve some medical expenses on your medical insurance card, it cannot be used in the outpatient medical institution at the same time.
2。 Reimbursement: When using medical insurance card to see a doctor in other hospitals during hospitalization, it is necessary to ensure that the medical records and medical expenses list issued by outpatient medical institutions conform to the medical insurance policy, otherwise medical expenses may not be reimbursed. It is suggested that when visiting outpatient medical institutions, we should know the medical institutions' medical insurance reimbursement policies in time so as to carry out correct reimbursement operations.
3。 Medical quality: If you use a medical insurance card to see a doctor in another hospital during hospitalization, the medical quality, medical technology and medical equipment of this outpatient medical institution may be different from that of the inpatient medical institution. Therefore, it is suggested that when choosing outpatient medical institutions, choose medical institutions with high credibility and high medical level. To sum up, if you need to go to other medical institutions for outpatient treatment during hospitalization, it is recommended to know the medical institutions' medical insurance reimbursement policies and charging methods in advance, and pay attention to medical quality and technical issues.
First, about medical insurance reimbursement.
The insured shall pay the medical expenses such as the list of insurance drugs, diagnosis and treatment items, standards of medical service facilities, emergency rescue, etc. of the basic medical insurance premium according to the regulations of the state, and shall not be included in the scope of medical insurance reimbursement according to the partial scope stipulated in the Social Insurance Law of People's Republic of China (PRC).
Two, social security medical payment for several months of medical expenses can be reimbursed.
General employees' medical insurance can be reimbursed in the second month of payment. However, if they have already participated in medical insurance before the company, and the payment has been interrupted for more than three months due to resignation, they must wait for six months to enjoy reimbursement. According to the relevant laws and regulations, medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, and emergency and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
3. What is the reimbursement scope of basic medical insurance?
The basic medical insurance co-ordination fund and individual account shall delimit their respective payment scope and be accounted for separately. Medical expenses that meet the payment scope of the basic medical insurance fund shall be reimbursed in accordance with the list of basic medical insurance drugs, the list of diagnosis and treatment items, the scope of service facilities and the payment standard stipulated by this Municipality. The specific provisions are as follows:
1, personal account pays the following medical expenses.
Outpatient and emergency medical expenses; The cost of purchasing drugs at designated retail pharmacies; Medical expenses below the Qifubiaozhun of the basic medical insurance pooling fund; Medical expenses that exceed the qifubiaozhun of the basic medical insurance pooling fund and should be borne by individuals in proportion. The insufficient part of personal account shall be paid by myself.
2, the basic medical insurance fund to pay the following medical expenses
Hospitalization medical expenses; Emergency rescue observation and income hospitalization, medical expenses within 7 days before hospitalization observation; Outpatient medical expenses of taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and renal transplantation for malignant tumors.
To sum up, try to be treated in the hospital to avoid later troubles.
Legal basis:
Article 2 of People's Republic of China (PRC) Social Insurance Law
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.