Related knowledge: medical insurance card (referred to as medical insurance card) is a special card for medical insurance personal account, personal identification card as the identification code, stored in the record of the personal identity card number, name, gender, and the account of the allocation of funds, consumption and other details of information. The medical insurance card is organized by the local designated agent bank and is a kind of multi-functional debit card of the bank. After the insured unit pays its contribution, the local medical insurance department will entrust the bank to pay the part of the individual account fund to the insured employee's personal medical insurance card at the end of the month.
I. Reasons for freezing the medical insurance card
1. The medical insurance card may be frozen because of a wrong password, the employer pays the fee too late, or the flexibly employed person forgets to pay the fee on time.
2, wrong password, according to bank regulations, medical insurance card withdrawal password three consecutive wrong will be locked, can not be deducted, but after 24 hours will be automatically unlocked. If it is not unlocked, you can go to the counter of your local bank (the bank of your health insurance card) to reset the password of your health insurance card.
3. If the employer pays too late, the employee's health insurance card may be frozen if the employee's employer fails to pay the enrollment fee in time, or focuses on payment in the last few days at the end of the month.
Flexible workers forget to pay their contributions on timeMany flexible workers forget to pay their health insurance premiums on time, so their health insurance cards are easily frozen. Some of them pay and pay, stop for a period of time, and do not make up for it later. In this case, re-enrollment usually requires a six-month waiting period, and they can't enjoy the health insurance benefits for the time being.
Suzhou medical insurance card reimbursement scope
Use of medical insurance card and its basic medical costs and outpatient use of local supplementary medical insurance drug directory of drugs, diagnostic and therapeutic items of the cost of payment by the individual account; individual account is not enough to pay, its outpatient basic medical costs in the medical insurance year more than the city of the previous year's average annual salary of urban workers of more than 10% of basic medical costs by the basic medical insurance pool fund pays 70%, and the basic medical insurance pool fund pays 70%, and the basic medical insurance pool fund pays 70%. The basic outpatient medical expenses exceeding 10% of the average salary of urban workers in the previous year within the medical insurance year shall be paid by the basic medical insurance fund at 70%, and the individual shall pay 30% out of pocket. When a medical insurance participant undergoes outpatient large-scale medical equipment examination or treatment on an outpatient basis due to the needs of his/her condition and after approval by the municipal social insurance institution or the medical institution authorized by the municipal social insurance institution, 80% of the costs will be paid by the basic medical insurance co-ordination fund, and the individual will pay 20% of the costs out of his/her own pocket. The examination items and treatment items of large-scale medical equipment shall be determined by the municipal social insurance organization.
Three, how to use the Suzhou medical insurance card?
1, health insurance is divided into two accounts, personal account, embodied in the health insurance card money, can be used to buy drugs at designated pharmacies, outpatient payment and hospitalization costs in the payment of personal out-of-pocket part of the payment; co-ordinated account, managed by the health insurance center, the insured person occurs in line with the local health insurance reimbursement of the cost of the co-ordinated account to pay.
2, in the medical treatment, to the designated hospital to show the card to prove the identity of participants and registration, the part of the reimbursement by the medical insurance and the hospital settlement, individuals do not need to pay and then reimbursement, in the settlement of the bill, the individual out-of-pocket part of their own medical card balance and cash payment.
Fourth, note
1, employers and insured people did not pay on time or interrupt the payment of health insurance premiums, the individual account of the insured person from the next month onwards, frozen, suspended to enjoy the employee health insurance treatment. During the freezing period, the balance of the individual account in previous years and the amount of the current year's pre-scheduled amount cannot be used.
2. If a participant transfers out of the city or dies, the individual or unit should go through the procedures of liquidating the amount in the individual account of the medical insurance in a timely manner.
Personal advice: There are some differences in the use of health insurance cards in different parts of the world, and China has not yet implemented a nationwide network, so the use of health insurance cards is still limited to the place of insurance.
Legal basis: "The People's Republic of China *** and the State of urban workers' basic medical insurance regulations" Chapter VI of the organization and management of the basic medical insurance and supervision
Article 48 of the provincial administrative department of labor and security is the province's urban workers of the basic medical insurance of the administrative authority, its duties are:
(1) the preparation of basic medical insurance for employees;
(2) to formulate, in conjunction with the relevant departments, the financial management system, statistical system and internal audit system of the basic medical insurance fund;
(3) to supervise and manage the work of the province's basic medical insurance, and exercise the right to impose administrative penalties in accordance with the law;
(4) to make an announcement to the public annually on the work of the basic medical insurance;
(5) to make an announcement to the public on the work of the basic medical insurance; < /p>
(v) other duties that should be performed by the competent administrative organs. The labor security administrative departments of cities, counties and autonomous counties shall, in accordance with the regulations, manage and supervise the work of basic medical insurance for urban workers in their administrative areas.
Article 49: Social insurance agencies are responsible for administering the basic medical insurance business for urban employees, and their duties are:
(1) to be responsible for registering for basic medical insurance;
(2) to manage the basic medical insurance fund;
(3) to supervise the medical services of basic medical insurance;
(4) to be responsible for paying out the basic medical insurance benefits;
(v) proposing the preparation of budgets and final accounts for the expenditures of the basic medical insurance fund;
(vi) carrying out inspections and investigations related to basic medical insurance upon the entrustment of the administrative department of labor security;
(vii) being responsible for preservation of the value of, and increasing the value of, the basic medical insurance fund in accordance with the state regulations;
(viii) providing consultation and other services relating to basic medical insurance policy consultation and other services;
(ix) be responsible for other basic medical insurance matters stipulated by the state and the province.