The city's secondary and above designated medical institutionsAll of them are regarded as alternative outpatient clinics for employee medical insurance participants. Employee medical insurance outpatient mutual aid treatment,The maximum annual payout limit is $400There is no minimum payment standard.
On December 14, the Qingyuan Municipal Medical Security Bureau issued the "Notice on Optimizing and Adjusting the Relevant Policies of the Outpatient Mutual Aid Security of the Employee Medical Insurance in the City" to optimize and adjust the relevant policies of the outpatient mutual aid security of the employee medical insurance. The details are as follows:
A) cancel the restriction on the selection of a secondary and above designated medical institution for employee medical insurance outpatient clinics, and the city's secondary and above designated medical institutions are regarded as alternative outpatient clinics for employee medical insurance participantsEmployee participants are no longer required to select alternative outpatient clinics, inAll designated medical institutions at or above the second level in the city can settle alternative outpatient medical expenses in a "one-stop" manner and enjoy outpatient mutual aid treatment
2) Mutual aid treatment for outpatient medical insurance for employeesThe maximum annual payment limit is 400 yuan, and there is no minimum payment standard。In-service employees in the city's second-level and above designated medical institutions are in accordance with the regulationsThe proportion of medical expenses paid for general outpatient services is uniformly 70%, and the proportion of medical expenses for retirees is increased by 5%.
3) All medical security departments should do a good job in policy publicity, guide designated medical institutions to implement the mutual aid guarantee of employee medical insurance outpatient services, standardize diagnosis and treatment behaviors, and guide employee insurance to seek medical treatment in an orderly manner. The Municipal Medical Security Service Center is responsible for doing a good job in policy publicity and treatment adjustment to ensure that the notice is in place.
This notice will come into force on January 1, 2024。In the event of any inconsistency between the previous provisions and this Notice, this Notice shall prevail. Where the state or province has other new provisions, follow those provisions.
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The relevant person in charge of the Qingxin Branch of the Municipal Medical Security Bureau explained that from January 1, 2024, the alternative outpatient mutual aid of the employee medical insurance will be fully opened, and the city's secondary and above designated medical institutions will be the alternative institutions for the employee medical insurance participants by default, and the insured does not need to go through the alternative proceduresThe originally selected designated medical institutions for general outpatient services can still apply for change
At that time, the insured can be reimbursed for the outpatient mutual aid expenses of employees in the city's secondary and above designated medical institutionsThe reimbursement rate is uniform at 70 per cent, with a corresponding increase of 5 per cent for retireesThe reimbursement rate of general outpatient expenses in the original selected first-class medical institutions remains at 85%, and the reimbursement rate for retirees is 90%.
*:Qingyuan** Qingyuan Medical Security Bureau Qingqing Branch.
Editor: Hu Ruqing.