04Evidence A

Before seeking medical care outside your home province, ask locally first — the need for such care should ideally be assessed by an associate chief physician or higher.

Whether a patient needs to travel elsewhere for treatment should, in principle, be evaluated by doctors holding the rank of associate chief physician or above at secondary or tertiary hospitals. Reimbursement rates for temporary out-of-area treatment differ from those offered at local hospitals of comparable level; exact terms depend on local regulations. Asking locally beforehand is far better than discovering later that no reimbursement is possible.

Cost

No cost involved. It simply requires asking a few extra qu…

Benefit

The necessity of receiving medical care across different healthcare regions or provinces must, ideally, be ass…

Cost

No cost involved. It simply requires asking a few extra questions beforehand.

Benefit

The necessity of receiving medical care across different healthcare regions or provinces must, ideally, be assessed by qualified physicians at secondary or tertiary hospitals holding the rank of associate chief physician or higher. “Cross-regional care” refers to treatment sought outside one’s designated medical insurance area. This assessment must be performed by doctors meeting the required qualifications. Reimbursement levels for temporary out-of-province patients also differ reasonably from those at local hospitals of the same level; consequently, patients receive less coverage for identical treatments received elsewhere.

Original sources

国务院办公厅 (2026). 关于加快建设分级诊疗体系的若干措施. https://www.gov.cn/zhengce/zhengceku/202604/content_7065031.htm:「原则上由二、三级医院副主任医师及以上职称人员评估患者跨统筹地区、跨省异地就医的必要性。」「进一步强化异地就医直接结算管理服务,跨省临时外出就医人员报销水平与参保地同级别医疗机构报销水平保持合理差异。」

Open source link
Book note

“Temporary out-of-area treatment” and “long-term residence elsewhere” constitute two distinct registration categories, each with different reimbursement levels. Details regarding registration procedures and which conditions qualify for direct settlement are covered in Section 16. Do not travel to another province first and then worry about reimbursement later.

My note