New crown patients can be reimbursed 75% for outpatient visits to 347 medical institutions at the second level and below in Yantai City

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Since January 8 of this year, 347 secondary and lower medical institutions in the city have implemented the policy of paying 75% of the new crown outpatient medical insurance, and many citizens have already enjoyed the policy benefits. The policy is implemented first until March 31.

There is no starting and capping line for emergency outpatient reimbursement

On January 31, she went to a hospital in Huang Bohai New District, where the doctor took lung images, did routine blood tests and prescribed cough medication according to her condition. The total cost of Ms. Li’s visit was $287.75, but in the end, her personal account only paid $71.90.

“Your case belongs to the new coronavirus infection, which can be paid 75% by the medical insurance fund according to the latest regulations.” The hospital medical insurance department staff replied. Ms. Li was thrilled to learn about this beneficial policy: “It’s great that the new coronavirus infection can be reimbursed by medical insurance!”

The reporter learned that, according to the document Lu Medical Insurance Development [2023] No. 1, starting from January 8, 2023, the policy scope of outpatient and emergency medical expenses related to the treatment of new coronavirus infection incurred by the insured patients in primary medical insurance designated medical institutions (secondary and lower medical institutions) in our city, there is no starting line and no ceiling line, and the reimbursement rate is 75%. The policy will be implemented first until March 31, 2023. The outpatient and emergency expenses for the treatment of neocoronavirus infection incurred by the insured patients in the tertiary designated medical institutions are not entitled to special protection and are implemented in accordance with the basic medical insurance outpatient protection policy. Participating employees can be reimbursed in accordance with the employee general outpatient policy.

Inpatients will be unified organization clearing

Inpatient medical expenses incurred by patients with new coronavirus infection in all admitting medical institutions and in accordance with the treatment plan for new coronavirus infection formulated by the health and wellness department will continue to be implemented in accordance with the prior cost protection policy, and the individual portion of the burden will be subsidized by the government after payment by basic medical insurance, major medical insurance and medical assistance in accordance with regulations.

The policy is calculated by the patient’s admission time, the first implementation until March 31, 2023. The reporter understands that the city has not yet issued a liquidation plan, and patients who are discharged from the hospital with their personal burden not enjoying the subsidy will be compensated by the relevant departments after the liquidation plan is issued.

The scope of protection is limited to the costs included in the treatment plan

The reporter learned from the medical insurance office of Zhifu District only Chu Hospital that the outpatient and emergency medical procedures for new coronavirus infections are divided into six steps (see the chart below for details).

Only Chu Hospital medical insurance office staff reminded that patients need to hold their own medical insurance electronic voucher or social security card to seek medical treatment. New Coronavirus outpatient coverage is limited to the cost of treatment related to New Coronavirus infection as stipulated in the national “New Coronavirus Infection Treatment Plan”, other diagnoses should be prescribed separately and cannot be combined with New Coronavirus outpatient prescriptions for settlement.