Bass The chronic disease card cannot only be used in the hospitals designated when applying for the card. The specific scope of use should be determined based on the medical insurance policy of the insured place. Last year, when I helped an elderly person in my family apply for a chronic disease card for hypertension, the community staff specifically reminded us to choose two designated hospitals close to home. I thought at the time that I would only be able to go to these two hospitals to get reimbursement for medicines. However, within two months, the elderly person went to the Provincial People's Hospital for a follow-up visit. When I checked out, I swiped the chronic disease card and the reimbursement share was directly deducted. When I asked, I found out that our local area had relaxed the chronic disease reimbursement restrictions for second-level and above public designated hospitals as early as 2022. The previously selected designated hospitals only enjoyed a higher reimbursement ratio, not just those two.
Of course, not all places have relaxed restrictions. Some time ago, I saw some netizens complaining in a medical insurance-related exchange group that the reimbursement for chronic diseases in their hometown county is still stuck at the three originally selected designated hospitals. If you want to get medicine from a tertiary hospital in the city, you have to go to the Medical Insurance Bureau a week in advance to change the designated site, otherwise you will not be able to reimburse for the prescribed medicine. If you are seeking medical treatment in a cross-coordinating area, the requirements are even greater. You must first complete the registration for medical treatment in another place, and it can only be used in hospitals that have opened inter-provincial direct settlement of chronic special diseases in the registration area. Otherwise, you have to pay the fee in advance, and then take the receipt back to the insured place for reimbursement.
Speaking of this, some people may wonder, since things are slowly being relaxed now, why did you have to choose a certain location to apply for a card in the first place? In fact, the reimbursement setting points for chronic and special diseases in the early years were essentially to control fund risks. After all, most chronic diseases require long-term medication, and the reimbursement ratio is much higher than that of ordinary outpatient clinics. In the early years, the medical insurance system was not connected, and patients’ prescription records could not be tracked across institutions. It was easy for repeated prescriptions and excessive prescriptions to rob medical insurance. The setting point is equivalent to narrowing the scope of supervision, making it easier for the medical insurance department to verify the rationality of medication use.
In the past two years, with the implementation of the national networked medical insurance system, the entire process of patients' prescription and medical treatment records can be checked, and many places have gradually relaxed restrictions on designated retail pharmacies, and even included designated retail pharmacies that meet the requirements into the scope of use of chronic disease cards. The pharmacy downstairs of my home hung a sign of "Designated Pharmacy for Chronic Special Diseases" last month. Now the elderly can buy antihypertensive drugs downstairs and report them, and no longer have to queue up at the hospital every week. If you are not sure about the scope of use of your local chronic disease card, it is best to call the hotline of the local medical insurance bureau to find out in advance, so as not to be like what my colleague’s father did last time. When he went to visit relatives out of town, he ran out of medicine and prescribed medicine at the local hospital only to find out that it could not be reported without registration in another place, which cost hundreds of dollars.
