New Provisions on Medical Insurance Reimbursement in Gansu Province 2023

The new provisions of medical insurance reimbursement in Gansu Province in 2023 are as follows:

According to the Notice of Gansu Provincial Medical Insurance Bureau and Gansu Provincial Department of Finance on the Detailed Rules for the Implementation of the Basic Medical Insurance for Outpatients in Gansu Province (No.74 [2022] of Gansu Medical Insurance), from June 5438 to 10/day, 2023, Gansu Province adjusted the employees and retirees in the whole province to be included in the medical insurance card policy and standard, and included the outpatient medical expenses in the payment scope of the employee medical insurance pooling fund. At the same time, personal accounts can be used by families.

The medical insurance card can be used not only to pay the out-of-pocket expenses within the policy scope of designated medical institutions or designated retail pharmacies, but also to pay the medical expenses incurred by spouses, parents and children in designated medical institutions.

And the expenses incurred by individuals in purchasing drugs, medical devices and medical consumables at designated retail pharmacies; Spouses, parents and children who participate in the basic medical insurance for urban and rural residents can also pay their personal contributions with medical insurance cards.

Settlement method of serious illness insurance for urban and rural residents in Gansu:

In order to facilitate the discharge of urban and rural residents and realize the connection between basic medical insurance, serious illness insurance and medical assistance, it is clearly stipulated in the implementation plan that urban and rural residents should seek medical treatment in medical institutions that are interconnected by information technology and can be settled immediately: when they are admitted to hospital, they should submit their enrollment certificate, identity certificate, minimum living guarantee certificate, support certificate for poor people, "one card" and bank account together.

Carry out "one-stop service" in turn according to the process of "basic medical insurance and medical assistance"; If an individual who meets the conditions of a single hospitalization exceeds the self-funded Qifubiaozhun, the commercial insurance institution shall promptly compensate the medical insurance expenses for serious illness; The self-funded expenses for single hospitalization compliance did not exceed the deductible.

However, for those who have been hospitalized many times during the year and accumulated more than Qifubiaozhun, the insurance institution will give one-time compensation at the end of the settlement year, and carry out "one-stop service" in turn according to the process of "basic medical insurance, serious illness insurance and medical assistance".

The above internal reference: Gansu government service network-Gansu medical insurance outpatient service will be included in this newspaper on June 65438+ 10/.