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Zhenjiang City, collected about the content of the health insurance medical insurance card introduction, to provide you with information about the use of Zhenjiang City, medical insurance medical insurance card process, the use of medical insurance card, medical insurance card replacement and replacement address and other related content, I hope to help you.
How to use
1, the use of health insurance card:
Participating workers in the designated hospitals, pharmacies, medicine purchase, with the password in the POS machine card, but can not withdraw cash or transfer use.
2. Balance inquiry of medical insurance card:
Participating employees can inquire about the balance by calling the telephone, or in the savings office of the Bank of China or the designated hospitals and pharmacies in the city. You can also go online and log in the social security query system to check.
3, medical insurance card transaction inquiry:
Participating employees can go to the savings office of the Bank of China with their ID cards and medical certificates to request a printout of the medical insurance card transaction records, including individual account fund disbursement records and consumption records. If you have any questions about the transaction records, you can go to the retail business department of BOC to make inquiries.
4. Password of medical insurance card:
If the insured employee changes the password, he/she can call the phone number to change it, or he/she can bring his/her ID card to the savings office of BOC to change it. If the insured employee forgets his/her password, he/she can go to the savings office of the Bank of China with his/her ID card to lose his/her original password and change his/her password.
5. Custody of medical insurance card:
Participating employees should take good care of their medical insurance cards. If they lose their cards inadvertently, they should immediately go to their units to issue a letter of proof and go to the medical insurance office to confirm the loss with their ID cards and go to the savings office of BOC to register the loss of their cards and go through the procedure of replacing the cards, and then they can get the new cards after 7 days.
6. Notes:
When the number of transactions on the medical insurance card reaches 60, the insured employee must go to the savings office of the Bank of China to print the transaction records, otherwise, the use of the card will be stopped. After the transaction records are printed, the card can continue to be used.
At the pharmacy, 100% of the cost is borne by oneself, and hospitalization is the only way to enjoy the reimbursement rate (it must also be within the scope of medical insurance).
Hospitalization in the health insurance coverage, depending on the actual amount spent, such as: spend 10,000 reimbursement between 55%-65%.
Using the process
Patients with medical insurance card to go to the hospital after illness, then the process of medical insurance card to go to the medical insurance designated units are as follows:
With the medical insurance manual and IC card - the hospital medical insurance office registration - the examination of the validation of the card - the payment of hospitalization deposit - hospitalization - the self-payment of the items need to be agreed upon by the patient and signed - the starting point for settlement of cash or IC card standard and out-of-pocket expenses The out-of-pocket part of the starting standard and out-of-pocket percentage - within the scope of the co-ordination of the hospital first advance - settlement of the discharge.
The settlement of hospitalization expenses adopts the postpaid service item settlement method.
Specified hospitals use health insurance cards
1, in the designated hospitals when you show your health insurance card to prove your insurance status and registration, you do not need to pay before reimbursement, you can directly by the medical insurance and the hospital to settle the reimbursement of the part of the medical insurance, and only in the billing, the part of the out-of-pocket expenses will be paid by yourself with the balance of the health insurance card or in cash.
2, hospitalization reimbursement, there is a starting line (the starting standard is generally 10% of the average annual salary of the city's employees in the previous year), that is to say, the starting line of the money you need to pay, more than the starting line of the part of the reimbursement of the local health insurance regulations, reimbursement rates are not the same everywhere, and different hospitals and different projects are not the same, about 80%, the details of the local labor security online to learn. You can go to the local labor security network to learn more about it.
Instructions
Functions
Medicare card is a chip-containing functional card used for identification and payment of individual account for medical or pharmacy consumption. For example, the initial password of the medical insurance card in Wuhan is 1234. Medical insurance medical record, a kind of medical record, can be generalized to all medical insurance designated hospitals in the same city, used to record the medical insurance medical condition.
Can I be reimbursed for social security medical insurance?
The so-called medical insurance hospitalization reimbursement - not you advance cash later reimbursement with bills, but in the medical insurance designated hospital hospitalization, issued by the medical insurance card, so that the unified medical insurance billing system to read the information of the participant, hospitalization number, in the discharge settlement, the medical insurance system does not charge you". The "reimbursable" portion - the part paid by the unified payment.
Outpatient reimbursement
Resident medical insurance:
In an insurance year, the resident medical insurance fund pays 30% of the general outpatient expenses incurred by the insured residents at the outpatient designated medical institutions up to and including 100 yuan, and the individual pays 70% of the expenses; the individual pays for the expenses of more than 100 yuan.
Urban workers' medical insurance:
The individual account on the medical insurance card of the insured person who is insured by the unit is not all the part paid by the individual; the individual account of 15 yuan per month on the medical insurance card of the flexibly employed person from the previous year can be used to pay for outpatient expenses, which is equivalent to the reimbursement of outpatient expenses (except for those who belong to the civil servants or the unit has other reimbursement policy).
Medicare hospitalization, show your health insurance card, read the card into the health insurance system, pay a deposit (generally threshold fee), the costs incurred are entered into the system, the system is automatically categorized as out-of-pocket, Category A, Category B, etc., Category B first 10% out-of-pocket, and then into the basic medical care, in accordance with the number of times of hospitalization per year (greater than 1 threshold fee is reduced by half), the level of the hospital (threshold fee is different, different proportion of the overall), by the computer to calculate how much money should be paid, and the hospital then to the social security system. Pay how much money, the hospital and then to the social security of the health insurance center to settle how much money.
You can check online at your local social security website. Any insured person, with ID number in the home page of the site "personal inquiry", enter the ID number, according to the requirements of the ID number of the 12th to 17th password, enter, point "personal inquiry" - - point "medical insurance fixed" - - point "medical insurance fixed" - - point "medical insurance fixed" - - point "medical insurance fixed" - - point "medical insurance fixed" - - point "medical insurance fixed -Point "Medical Insurance Designated Organization" or "Medical Insurance Designated Pharmacy" inquiry. The site can also inquire about the cardholder's payment status, personal account balance, and historical consumption.
Zhenjiang City, social health insurance content notes
Replacement process
At this stage of the medical insurance card demagnetization, loss, according to the regulations will be directly replaced by a social security card, the specific process:
If the replacement of the card before and after the same bank, the process of receiving social security cards:
1, I have to the valid documents to the employee medical insurance card service bank for Lost procedures;
2, the street labor security service center with the bank's "lost notice" and my valid documents, acceptance of social security card claims, the time for 45 working days;
3, received the social security card and funded, the amount of money in the original health insurance card is automatically transferred to the social security card, without having to clear the account.
If the bank is not the same before and after the card replacement, the process of receiving the social security card:
1. The amount in the original medical insurance card will not be automatically transferred to the social security card, and you need to go to the social security sub-center of the insured district with your valid documents to issue the "Employee's Medical Insurance Card Clearance Notice";
2. Go to the service bank of the original employee's medical insurance card with the notice and your valid documents to handle the The medical insurance card account clearing.