Can I use medical insurance card for medical examination in Guangzhou 3A hospital?

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Can the medical insurance card have a physical examination in a 3A hospital?

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Shi Jing Zhou Jie lawyer legal expert

2022-03- 15 lawyer

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Medical insurance cards are generally not available for physical examination. If you make an appointment online, you need to pay the medical examination fee through online banking, Alipay or WeChat. If you need to confirm whether the medical insurance card can be used normally in real time, please call the physical examination center for details.

According to the relevant provisions of the Social Insurance Law of People's Republic of China (PRC), employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. This part of the fee is not used for medical examination.

Extended data

People's Republic of China (PRC) social insurance law

Article 24 The state establishes and improves the new rural cooperative medical system.

Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.

Article 25 The state establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

Answer in March 2022-15

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Can I use a medical insurance card for a medical examination in a 3A hospital?

Legal analysis: Generally speaking, the medical insurance card cannot be used for health examination and on-the-job examination in hospitals or medical examination centers, and generally it cannot be reimbursed. Reimbursement with medical insurance card can enjoy the rights of citizens, including the following aspects: usually going to designated hospitals for medical treatment, outpatient service, prescription and hospitalization, and only within the scope of medical insurance. In terms of emergency treatment, the insured can also enjoy medical insurance benefits if they receive emergency treatment in non-designated medical institutions or are hospitalized and transferred to designated medical institutions within a certain period of time. If it is not within the above range, such as health examination, it is not allowed to use the medical insurance card. Legal basis: Article 2 of the Social Insurance Law of People's Republic of China (PRC) The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., to protect citizens' right to get material help from the state and society according to law in case of old age, illness, industrial injury, unemployment and maternity. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Lawyer Lu Lin Xiaodong

Answered on April 28, 2022

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Can I use a medical insurance card for a medical examination in a 3A hospital?

Generally speaking, the medical insurance card cannot be used for health examination and on-the-job examination in hospitals or medical examination centers, and generally it cannot be reimbursed. Reimbursement with medical insurance card can enjoy the rights of citizens, including the following aspects: usually going to designated hospitals for medical treatment, outpatient service, prescription and hospitalization, and only within the scope of medical insurance. In terms of emergency treatment, the insured can also enjoy medical insurance benefits if they receive emergency treatment in non-designated medical institutions or are hospitalized and transferred to designated medical institutions within a certain period of time. If it is not within the above range, such as health examination, it is not allowed to use the medical insurance card. 1. Can I swipe my medical insurance card 1 to get medicine in the hospital? Scope of use of medical insurance card: When insured employees go to designated hospitals and pharmacies for medical treatment, they can swipe their cards on POS machines with their passwords, but they cannot withdraw cash or transfer money. 2. Inquire about the balance of medical insurance card: Insured employees can inquire about the balance by telephone, or at the Bank Savings Office of China or the designated hospitals and pharmacies in the urban area. You can also log in to the social security inquiry system online. 3. Inquiry of medical insurance card transaction: Insured employees can print medical insurance card transaction records, including personal account payment records and consumption records, at China Bank Savings Office with their ID cards and medical insurance requirements. If you have any questions about the transaction records, you can go to the retail business department of Bank of China. 4. Medical insurance card password: The insured employees can change their passwords by phone or bring their ID cards to the Bank of China Savings Office. If the insured employee forgets his password, he can report the loss of the original password with his ID card to China Bank Savings Office and change it. 5. Custody of medical insurance card: Insured employees should keep the medical insurance card properly. If they accidentally lose it, please immediately issue a letter of proof to the unit and stamp it in the medical insurance office for confirmation. Then, they will take their ID cards to China Bank Savings Office to report the loss and go through the formalities. After 7 days, they can get a new card. 6. Precautions: When the number of medical insurance card transactions reaches 60, the insured employees must go to China Bank Savings Office to print the transaction records, otherwise they will stop using the card. After the transaction record is printed, the card can continue to be used. In the pharmacy 100% will bear it by itself, and hospitalization can only enjoy the reimbursement ratio (which must be within the scope of medical insurance). If the hospitalization is within the scope of medical insurance, the scope of reimbursement is between 55% and 65% according to the actual amount of expenses incurred, such as 10000 yuan. Second, can medical insurance be reimbursed for hospital examination? Outpatient examination fees cannot be reimbursed by medical insurance. The process of applying for medical insurance reimbursement is: 1. After the patient is admitted to the hospital, the medical insurance patient can register in the hospital with his ID card, medical insurance card and other documents; 2. When the patient is discharged from the hospital to settle the medical expenses, it is necessary to wait until the admission fee office handles the discharge settlement formalities with the admission registration form and ID card, and there is no need to submit an expense account to the social security center; 3. After being audited by relevant departments, the applicant can receive the Social Medical Insurance Medical Expense Reimbursement Form for reimbursement. 1. The following medical expenses are not included in the payment scope of the basic medical insurance fund: 1, and should be paid from the industrial injury insurance fund; 2, should be borne by a third person; 3, should be borne by public health; 4. Go abroad for medical treatment. Second, the scope of use of the medical insurance card includes: 1, and the insured person purchases medicines at designated pharmacies; 2, in the designated hospital outpatient medical treatment, personal account funds available medical insurance card to pay related expenses; 3. It can also be used to pay the hospitalization expenses borne by individuals in the hospitalization expenses. In short, the hospital examination is not covered by the basic medical insurance fund, and medical insurance cannot be reimbursed. Article 2 of the Social Insurance Law of People's Republic of China (PRC) establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in case of old age, illness, industrial injury, unemployment and maternity. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Lawyer Li Li

2022- 12- 17 answer.

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