For a common illness, start at the community clinic, go up by stepwise referral, and let the inpatient deductible carry forward

Go to the community clinic first. If the clinic then refers you to a large hospital for a stay, the stretch you pay at the start carries forward, and you do not pay that stretch a second time. How the arithmetic works is set locally. In Sichuan you only make up the difference between the hospitals' deductibles. If a large hospital transfers you back to the community clinic to continue the stay, the same illness is not calculated again during that period.

Cost

No money. You do have to make a trip to the community clinic first. The hard part is holding back from booking a specialist directly.

Benefit

For an insured patient referred up step by step from primary care, the inpatient deductible at the higher hospital can be calculated continuously. The deductible is the stretch you pay yourself at the start of each hospital stay. Yibao (basic medical insurance) starts reimbursing only after that stretch is paid. The State Council document does not say how continuous calculation works in detail. Localities set that. Sichuan's method is to charge only the difference between the hospitals' deductibles. The county traditional Chinese medicine hospital has a deductible of 600 yuan. Transfer to the county people's hospital (deductible 800 yuan), and you only need to pay another 200 yuan. For an inpatient transferred down from a higher hospital back to primary care, no separate deductible is set again for the same illness in the same treatment period.

Notes

Referral rules are set separately by each province, each city, and each medical consortium. Ask the community clinic before you go. For a chronic illness that is stable, do not go back to a large hospital just to refill medicine, because ordinary outpatient visits of this kind at large hospitals will be cut back over time. A community clinic can prescribe 12 weeks of medicine at a time. See Section 16, item 5 (a community clinic can prescribe up to 12 weeks of medicine at a time).

Sources · 1

1. 国务院办公厅 (2026). 关于加快建设分级诊疗体系的若干措施. gov.cn/zhengce/zhengceku/202604/content_70650…：「统筹地区内经基层医疗卫生机构逐级转诊的参保患者，在上级医院的住院起付线可连续计算；由上级医院下转至基层医疗卫生机构的住院患者，同一疾病周期内不再另设住院起付线。」；四川省医疗保障局 (2025). 关于省第十四届人大第四次会议第14041026号建议办理答复的函. ylbzj.sc.gov.cn/scsybj/nc010414/2025/3/19/fea…：「仪陇县人民医院起付线是800元，仪陇县中医院起付线是600元，仪陇县中医院转仪陇县人民医院起付线只需要补200元差额即可。」