Q: What should I do if the information on the social security card I received is not the same as my ID card?
A: The social security card and ID card or a copy of the household register to the unit, which will be submitted to the district and county social security centers to re-create the card.
The social security card is an integrated circuit card (IC card) used in various business areas of labor and social security, which is uniformly planned by the Ministry of Labor and Social Security and issued by labor security departments around the world for the society. For urban workers, unemployed and retired people issued by the social security (personal) card, issued for the employer called social security (employer) card. The Ministry of Human Resources and Social Security (MOHRSS) said it will take about five years to make social security cards generally have financial functions. Hu Xiaoyi, vice minister of the Ministry of Human Resources and Social Security, told a news conference at the State Council Information Office on August 30, 2011, that the social security card adopts a unified national standard, and that the social security number adopts the citizen identity number in accordance with the relevant provisions of the Social Insurance Law.
Conceptual Interpretation
The full name of the social security card is the "People's Republic of China Social Security Card". From the meaning of this name, the issuance of the object is the government departments to implement the social security of the population; from its content, can involve all aspects of social security of the individual, including social insurance, including employment services, some areas of the local government in accordance with the needs of the local management, but also more social management services are also put into it; from the geographic area, this is a nationwide IC card can be used, can be adapted to the whole country. In terms of its geographical coverage, this is a nationwide IC card that can be used to meet the needs of the nationwide unified labor market and the networking of social security systems, as well as the needs of personnel mobility.
To correctly understand the concept of social security card, we must also be clear about the relationship between social security [1] card and other industry IC cards, especially with bank cards. Because the social security card for cardholders in the hospital settlement of the "personal account", similar to the bank card "electronic wallet", some regions or manufacturers will adopt the bank card standards to design social security cards. The bank card standard is a specification formulated for the application of bank cards, and its file storage format, command operation, security management and other aspects are designed for various transaction behaviors related to finance. The IC card issued in the field of labor security is mainly used for administrative management, and its main function is to manage information records, which is very different from the function of bank cards. The "medical insurance personal account" in the social security card is also fundamentally different from the "electronic wallet" in the bank card, which records the situation of the "account" in the personal account rather than the real "money". It is a record of the "account" in the personal account, not the real "money". After the cardholder transfers the balance of the personal account to the card, the medical insurance organization is still responsible for the use of the account, even if the cardholder's card is lost or damaged, as long as the funds on the personal account have not been fraudulently used by other people before the loss of the card, it will still be owned by the cardholder, and he or she can still use this part of the account to make medical consumptions. On the other hand, once the user deposits the money in the electronic wallet in the bank card, the money will have no relationship with the bank, and once the card is lost or damaged, the loss will be borne entirely by the cardholder. Therefore, health insurance personal accounts should never be handled in the mode of e-purse. There are also places where social security applications and financial applications are put on one card, which is not advocated, because putting commercial applications and management applications on one card will cause many drawbacks in management, bring much inconvenience to cardholders and management organizations, and even cause losses to cardholders.
2 carry out
Beijing local
Fengtai District social security card real-time settlement summary meeting
After the implementation of the card to seek medical treatment, the designated medical institutions for personal medical treatment is still based on the designated medical institutions selected by the medical insurance manual, and the A class, traditional Chinese medicine, and specialized hospitals can be directly access to medical treatment. [2]
No reimbursement without card
Participants who have received a social security card are required to present it when seeking medical treatment at designated medical institutions that have opened card-carrying settlement services. If the card is not presented, the costs incurred will be borne in full by the individual and will not be paid by the health insurance fund.
If an insured person seeks medical treatment due to emergency treatment, family planning surgery, enterprise fee arrears, during the period of replacing the card, or if the card has not been issued after enrollment in the insurance system, the medical expenses incurred can be advanced by the individual in cash and then reimbursed to the medical insurance agency in accordance with the original procedure.
Social security card in the process of replacing medical treatment must bring the "replacement (replacement) card certificate"
In the process of social security card replacement, if you are sick, do not have to be in a hurry. When you get a new card, the social security card service center will issue a "card replacement certificate" for you, and you can take the "card replacement certificate" to the designated hospital for medical treatment, and keep the prescription details and fee receipts to be reimbursed according to the original regulations.
The current outpatient starting line policy will remain unchanged after holding a social security card
The outpatient starting line standard will be the same as the original regulation after the insured person holds a social security card, i.e., the insured person's outpatient expenses will be deducted from only one starting line in a year: 1,800 yuan for the active staff and 1,300 yuan for the retired staff. The policy stipulates that outpatient medical expenses below the threshold are paid by the individual account funds, the city's individual account funds have been transferred to the bank passbook for free withdrawal, so medical expenses below the threshold need to be paid in full by the individual when seeking medical treatment. The part of the medical expenses that exceeds the starting line will be reimbursed according to the reimbursement rate stipulated in the policy, and the individual will only be responsible for the part of the medical expenses that should be paid out of pocket.
Participants should reimburse their outpatient medical bills as early as possible before using their social security cards. If the outpatient medical expenses incurred before receiving the card have not yet been declared, the outpatient medical expenses within the starting line need to be paid in full when the card is used for medical treatment, while the part of the expenses exceeding the starting line need to be paid only for their own out-of-pocket expenses and self-payment portion. Outpatient medical expenses not declared before receiving the card will be reimbursed by the district health insurance office in the same way as before, and the starting line will not be deducted again when reimbursement is made.
No change in the management of personal accounts after receiving the card
There is no adjustment to the current policy of personal account management. The amount of the individual account of the insured person after holding the card for medical treatment will still be transferred to the special passbook for medical insurance of the insured person in the Bank of Beijing on a monthly basis, and the funds of the individual account can still be withdrawn from the bank independently.
Outpatient registration and treatment fees are fixed at 2 yuan
Since June 1, 2009, outpatient consultation and treatment fees have been paid by the medical insurance fund at a fixed amount of 2 yuan, and the rest of the fees are paid in cash by the insured.
Zhejiang local
Lishui social security card data collection work conference
Social security card application schedule
According to the "Interim Measures for the Issuance and Management of Social Security Cards," "social security card issuance object for the city's household registration personnel as well as in accordance with the provisions of the city's human resources, social security public *** enjoyment **services and other social public ****services for persons not of the city's household registration." Social security card issue a wide range, in order to ensure the issuance of work in an orderly manner, the city's social security card application work schedule is announced as follows:
I. According to "Lishui city social security card data collection implementation program", the city's social security card issuance in accordance with the following order:
(a) urban workers basic medical insurance participants;
(b) Urban and rural residents' social pension insurance participants;
(iii) urban residents' medical insurance participants;
(iv) other objects.
The data collection of urban workers' basic medical insurance participants was completed by the end of 2011, and the issuance of social security cards on a citywide scale was basically completed by the end of 2013. Each county (city) should formulate its own work program according to the actual situation.
Two, according to the "city and district urban workers basic medical insurance personnel social security card application work implementation plan", in order to ensure that the city and district social security card application work is carried out in an orderly manner, the municipal level and Liandu District units will be carried out in accordance with the following time to apply for a social security card:
(a) September 10 to September 20, the trial issuance of card unit data collection.
(b) October 11 onwards, the city and district administrative organs and institutions batch application data collection. (Municipal units completed by November 5; district units completed by November 15)
(c) November 1 onwards, the city and district business units batch claim.
(d) From December 1, accepting individual sporadic claims.
3 Main Functions
Social security card face and card are recorded in the card holder's name, gender, civil status number and other basic information, the card identifies the cardholder's personal status (employment, unemployment, retirement, etc.), you can record the cardholder's social insurance contributions, pension insurance personal account information, medical insurance personal account information, vocational qualifications and skills, employment experience, work injury and occupational disease disability, etc. The social security card is an electronic voucher for workers in the field of labor security. Cardholders can use the card to seek medical treatment and settle their medical insurance accounts; they can use the card to handle pension insurance affairs; they can use the card to register for job-seeking and unemployment with the relevant departments, apply for unemployment insurance benefits, and apply for employment training; and they can use the card to apply for labor capacity appraisal and apply for work-related injury insurance benefits, etc. In addition, the social security card is also a means of holding the laborers' information. In addition, the social security card is also held in the hands of workers to open the door to contact with the system, with this key, the cardholder can go online to check the information, and in the future, you can also be on the Internet for labor and social security affairs.
4Types of cards
Blue card: used by people over 16 years old (including 16 years old)
Green card: used by minors under 16 years old
5Processing conditions
Those who are eligible to apply for the card can make an appointment by phone with a social security card application outlet or go directly to the social security card application service outlets on the streets (towns) to apply for social security cards (including school registration cards). (including school registration card). When applying for a social security card, you need to bring your ID card, household registration book, application form (citizens with a collective household registration need to bring a certificate of household registration issued by the police station or police station in the place where the household registration is located), and other relevant documents.
6 Questions and Answers
This year, the city issued a full range of social security cards, the number of people with a card in the increasing number of people, some of them do not quite understand how to use the social security card, in the process of card and reimbursement of medical encountered problems. Recently, the staff of the relevant departments to give answers.
Q: Before the use of social security cards, outpatient medical expenses have occurred, how to reimbursement?
A: The use of social security cards before the outpatient medical expenses that have occurred, to the unit or the social security institute in accordance with the original process of reimbursement, if you have used the social security card for medical treatment, you need to hand over the social security card at the same time. Q: Outpatient registration and treatment costs are not reimbursed at the same rate?
A: Since June 1, 2009, outpatient consultation and treatment fees are paid by the medical insurance fund at a fixed amount of 2 yuan, and the rest of the fees are paid in cash by the insured. It is worth stating that the medical insurance fund also pays a fixed amount of 2 yuan regardless of whether or not the medical expenses incurred by the patient this year exceed the starting line of outpatient consultation.
Q: Is the medical cost of purchased drugs settled in real time with the card?
A: Medical expenses incurred for purchased medicines are not settled in real time with the card, and are still operated according to the original settlement method.
Q: What are the special circumstances under which the insured can be reimbursed for the full amount of cash advance medical expenses?
A: In case of emergency without a social security card, family planning surgery, business arrears, manual reimbursement or replacement of social security cards during the period, after the participation of social security cards are not issued, the participants are still by the full amount of personal cash advances in medical expenses, can not be completed directly in the hospital real-time settlement, eligible for payment by the medical insurance fund, to be in accordance with the original process of manual reimbursement procedures.
Q: How to read the real-time settlement of bills?
A: real-time settlement of charges bill details, the amount of medical insurance coverage can be included in the total cost of medical insurance payments.
The medical insurance fund to pay: in accordance with the policy should be paid by the medical insurance fund the total amount of costs, including outpatient large medical, retiree supplemental insurance, disabled military benefits.
The medical expenses "borne by the individual" include three parts:
1. Out-of-pocket payment: medical expenses proportionally borne by the individual (including the starting line and the amount above the ceiling line);
2. Out-of-pocket payment: the amount in the catalog of Class B that needs to be borne by the individual (e.g., 10% of the out-of-pocket payment for the medical expenses of the Class B drugs);
2. Individuals pay 10% of the medical expenses);
3. Out-of-pocket expenses: medical expenses outside the scope of reimbursement (i.e., the three catalogs of medicines, diagnosis and treatment, and services and facilities);
The total amount of medical expenses for the current visit = payment by the current medical insurance fund + the current individual's burden.
Q: How should active-to-retired people change their social security card information?
A: For cardholder information, you can go to the social security agency in the district or county where the card issuer is located to synchronize the data.
Q: What are the problems that will occur if active-toretirees do not change their social security card information in time?
A: If an active employee does not change his/her information in time after retirement, he/she will still be reimbursed according to the outpatient threshold and reimbursement ratio of the active employee when he/she seeks medical treatment with his/her card, which may harm his/her rights and interests in medical insurance.
Q: Do I need to choose a hospital to get medical treatment with my card?
A: After the implementation of card medical care, the designated medical institutions for individual medical care will still be based on the designated medical institutions selected in the medical insurance handbook, and Class A, Traditional Chinese Medicine, and specialty hospitals can be directly accessed.
Q: insured persons with social security cards for medical treatment, the starting line has changed?
A: card access to the starting line after the standard remains unchanged: insured persons outpatient (emergency) clinic fees in a year only deducted a starting line: 1,800 yuan for active employees, retirees 1,300 yuan. The policy stipulates that medical expenses below the starting line for outpatient services shall be paid from the individual account funds. The portion of medical expenses exceeding the starting line will be reimbursed in accordance with the reimbursement rate stipulated in the policy, and the individual will only bear the part of medical expenses that should be paid out of his/her own pocket.
Q: What is the adjustment of the policy of personal account management after holding the card for medical treatment?
A: There is no adjustment to the policy of personal account management. The amount of the individual account of the insured person is still transferred to the special passbook of the Bank of Beijing on a monthly basis, and the funds in the individual account can still be withdrawn from the bank independently.
Q: If a participant who has received a social security card accidentally loses his medical insurance manual (blue book), what can he do? If the social security card is lost, how to replace it?
A: You need to go to the district or county social security center of the place where you are insured to apply for the procedure of replacing the medical insurance manual (blue book). When replacing the medical insurance manual (blue book), the unit needs to provide the social security card of the cardholder, and the district or county social security centers will synchronize and update the card information of social security cards for them.
Lost social security cards need to be replaced through the unit to the social security center in the district or county where the insured person is enrolled. The unit needs to provide the insured person's medical insurance manual (blue book) at the same time, and the district or county social security center will update the card information of the social security card for him/her synchronously.
Q: Where can I get my social security card?
A: Employees will receive their cards at their participating units; retirees will receive their cards at their original participating units; retirees under socialized management will receive their cards at the social security offices of their participating streets; and job referrals and talent filers will receive their cards at the job referral and talent service centers of their participating districts.
Q: After receiving the card, how can I change the wrong information in the card?
A: found that such a situation, most of the photos do not match the person, or the name of the same sound and different words. In all these cases, the cardholder should return the card to the district social security center through the unit.
Q: What should I do if the information on my social security card does not match that of my ID card?
A: Give the social security card and a copy of the ID card or household register to the unit, which will submit it to the district and county social security centers for re-making the card.
Q: How can I check the information on my card?
A: You can go to the card service outlets with the card and be helped by the staff to inquire, or self-service inquiry on the electronic touch screen of the self-service terminals with the card.
At present, the city's social security card service system mainly consists of four parts: social security card service outlets, social security card service hotline, social security card service website and social security card self-service terminals. Social security card service outlets are set up in more than 300 street social security offices in the city and 18 district and county social security centers and social security centers in the city's economic development zones, which are convenient for cardholders to handle social security card-related business; the social security card service hotline is "96102", which provides 24-hour service; and the social security card service network can be accessed by logging on to the Beijing Municipal Human Resource and Social Security Network. In addition, by logging into the Beijing Human Resources and Social Security Network, you can access the social security card service website interface. Self-service terminals for social security card services have been installed in social security card service outlets and designated medical institutions above the second level in the city, which can be used for inquiring medical insurance information and pre-loss functions.
Q: Why do some workers in the organization have cards and some don't?
A: The issuance of social security cards for the medical insurance database at zero hour on February 16, 2009, the point in time information, since then, the new participants and due to errors in the information comparison needs to be the second collection of information is not in the scope of the issuance of cards. As a result, some employees in the unit have cards and some do not.
Q: After the participants receive the card, how to determine the time of medical treatment with the card? Why do some units tell the participants that they can only use the social security card to settle medical bills in the second half of the year or year?
A: After receiving the social security card, the participants can go to the designated medical institutions with the card for medical treatment and real-time settlement. However, if there are any medical expenses paid in full by the individual before that, manual reimbursement procedures should be carried out in advance.
Q: The participants who have received the social security card, their hands of medical insurance manual (blue book) continue to use?
A: The social security card will be issued in phases and will be used in parallel with the medical handbook (blue book) until the social security card completely replaces the medical handbook (blue book). When the blue book is discontinued, a notice will be sent to the city to inform them.
Q: What if I forget my card at this visit?
A: Participants who have received their social security cards are required to present their cards when they visit designated medical institutions where card-carrying medical settlement services are available. If the card is not presented, the costs incurred will be borne in full by the individual and will not be paid by the medical insurance fund.
Q: How to open a social security card for the first time?
A: The social security card can be opened when the participant goes to a designated medical institution with the social security card and registers or pays the fee at the same time.
Q: How to see a doctor with a social security card?
A: First, you must present your social security card when registering for a consultation, pay the individual out-of-pocket and out-of-pocket expenses in cash, and the hospital will issue a bill for the insured person; second, when visiting the consultation room, you should take the initiative to present your social security card and the "Manual of Outpatient and Emergency Medical Records of Healthcare Institutions in the Beijing Area" to the doctor; third, when you are paying the bill, you must present the social security card and payment slip together with the social security card. Third, when you pay the bill, you should give your social security card and the bill to the billing officer to pay the self-payment and out-of-pocket expenses; finally, after you get the bill, you should check the contents of the bill carefully and take back your social security card.
Q: Retirees unified supplementary medical insurance whether at the same time the card settlement?
A: Yes.
Q: How can I see a doctor during the period of replacing (replacing) the social security card?
A: During the period of applying for the replacement of social security card, the insured persons need to take the initiative to present the "Certificate of Newly Issued and Replacement (Exchange) of Social Security Card" when they go to the designated medical institutions for medical treatment. The designated medical institution will collect relevant information according to the Certificate of Newly Issued and Replacement (Replacement) Social Security Card and upload the cost details. When the designated medical institution settles the medical expenses for the insured person, it will collect the full amount in cash and issue the relevant documents, and the insured person with the new social security card will declare the medical expenses according to the original process.
Q: How can the cardholder go to the designated medical institutions that do not have the conditions for swiping the card?
A: If the cardholder goes to a designated medical institution that does not have the conditions for swiping the card, he/she pays the full amount of the fee in cash first, and then the hospital issues the medical fee bill for the participant and uploads the details of the medical fee, and the participant will make the reimbursement of the outpatient medical fee with his/her social security card in accordance with the original process.
Q: After the occurrence of work-related accidents to seek medical treatment, how to distinguish whether the social security card should be used to settle in real time? If the real-time settlement, and then recognized as a work-related injury, how to solve the problem?
A: If it is determined that it is indeed a workplace accident, the medical expenses should be fully advanced and then reimbursed by the Workers' Compensation Insurance; if the real-time settlement is made and then recognized as a workplace injury, the insured person will be refunded for the real-time settlement of the expenses, and then fully advanced the medical expenses, and then the fully advanced medical expenses will be declared to the district and county medical insurance agencies for manual reimbursement.
Q: What are the circumstances that require a change in social security card information?
A: (1) Medical insurance in-service to retirement;
(2) Disabled military personnel new enrollment;
(3) Switching medical insurance insurance coverage;
(4) Approval of special diseases.
(5) Replacement of lost handbook.
Q: What should I do if I lose my social security card?
A: cardholders who have lost their social security cards can call the social security card service hotline "96102" (24-hour service) for telephone pre-loss. You can also take your resident ID card or household register to the social security card service outlets to apply for written pre-loss procedures, or directly in the social security card service outlets and above the second level of designated medical institutions set up self-service terminals for pre-loss. Pre-loss is valid for 10 days and will be automatically canceled after the valid time limit.
The person who loses his/her card determines that the lost social security card cannot be recovered, he/she needs to go to the social security card service outlets with his/her resident ID card to make an official loss registration, and at the same time go through the procedures of replacing the card.15 working days later, the person who applies for the replacement card goes to the social security card service outlets with his/her resident ID card or household registration booklet and the "Proof of New Issue and Replacement (Replacement) of Social Security Cards" (referred to as: "Proof of Receipt of the Card," see Attachment I) to get the Social Security Card. After applying for official loss, you cannot apply for revocation of loss.
7 Design for Use
The social security card is an electronic information card used by the medical insurance agency to verify the identity of the insured person for medical treatment and purchase of medicines, as well as to record and store the funds in the individual account and their use. With his social security card, the insured person can go to any designated medical institution in the city for medical treatment or designated retail pharmacy to purchase medicines. Cards are generally barcode cards, magnetic stripe cards, IC cards, IC cards are also called integrated circuit cards. Barcode card is the simplest kind of card, low cost, in 1996 Jinan Huiyin District to engage in health insurance pilot, the use of barcode cards, from the use of the effect, it is very poor, the reason is that it requires a very strong computer network to do the support, the customization of the workload is large; magnetic stripe card customization of the workload and the barcode card than the simple, but it is on the computer network requirements and the barcode card is the same; IC card is also known as the smart card or integrated circuit card, currently divided into three types, one is the memory card (MEMORY card), its integrated circuit is available electrically erasable programmable read-only memory.
Each city IC card socialization functions are basically the same, mainly around the labor and social security business services as the core of the five social insurance (medical, pension, work injury, maternity, unemployment) applications, which IC card medical settlement plays a leading core service functions, individual cities to carry out other related business services, set up a special financial area, increase the electronic wallet and the corresponding payment function. payment functions.
8 Hardware and Software System
The card system software includes key management system, card issuance management system, card management and maintenance system, transaction management interface, card query system, billing management, data network transmission, clearing management, HIS (Healthcare Information Management System), and abnormal transaction processing functions.
The hardware architecture of the social security card mainly includes: server, work terminal, initialization equipment, card reading equipment, encryption machine and so on.
9 One Card Functions
On August 21, 2011, the Ministry of Human Resources and Social Security (MOHRSS) stated that they were implementing the social security one card and deploying efforts to expand the application areas of social security cards. To this end, the ministry issued a Circular on Loading Financial Functions on Social Security Cards. The social security card loaded with financial functions can be used as a bank card with financial functions such as cash deposit and withdrawal, money transfer and consumption, in addition to the functions of information recording, information inquiry and business handling. In order to promote financial services for people's livelihood, and facilitate the public to enjoy social security benefits and financial services.
The financial application of the social security card with financial function is RMB debit application, and credit function is not supported for the time being. The card card media for contact chip card, can be used in the form of chip plus hidden magnetic stripe composite card temporary transition, the chip should contain both human resources social security applications and financial applications.
The Ministry of Human Resources and Social Security requirements, localities strive to use about five years, the basic realization of social security cards generally have the goal of financial functions. By the end of 2010, the number of social security cards issued in China was about 100 million, and by 2015, the end of the 12th Five-Year Plan period, the number of unified social security cards issued nationwide is expected to reach 800 million, covering 60 percent of the population.
Hu Xiaoyi, vice minister of the Ministry of Human Resources and Social Security (MOHRSS), introduced at a press conference held by the State Council Information Office on August 30, 2011, that the social security card adopts a unified national standard, and that the social security number adopts the civil identity number in accordance with the relevant provisions of the Social Insurance Law. From now on, the social security card will include financial functions and be unified nationwide.
References:
1.
Social security of the related information?
/cardbiz/BulletinChild/105/201052825831/news.htm
4.
2. Ministry of Human Resources and Social Welfare: social security card bank card "one card" in five years?
/politics/2011-08/22/c_121891641.htm
5.
3. social security card unified labeling Huai number using the civil identity number?
/news/1218,20110830159471457.html
6.
4. Social security cards will be loaded with bank card functions?
/a/20110831/000587.htm