If the medical insurance is interrupted due to state regulations, and the payment of basic medical insurance premiums is interrupted for three consecutive months or a total of six months, the basic medical insurance benefits will be stopped. After the payment is resumed, if the payment is suspended for 3 months, after 6 months of continuous payment, you can enjoy the payment treatment of the overall fund again. If the payment has been interrupted for 6 months, you can enjoy medical insurance benefits again after continuous payment of 1 year.
Provisions on withholding medical insurance:
1. If the insured person continues to pay medical insurance premiums within 60 days (including 60 days) after stopping paying medical insurance, he will enjoy the treatment of pooling funds from next month.
2. Stop paying medical insurance premiums for 60 days to 180 days (including 180 days) and continue to pay medical insurance premiums, counting from the payment month, and enjoy the treatment paid by the overall fund after 3 months.
3. Stop paying medical insurance premiums for more than 180 days, and continue to pay medical insurance premiums. From the month of payment, you will enjoy the treatment paid by the overall fund after 6 months. If the payment is overdue after the interruption, it will be regarded as re-participating in medical insurance, and the payment time before the interruption will not be included in the continuous payment time.
1. If the insured is referred to other medical institutions for diagnosis and treatment due to designated medical institutions or specialized diseases, the referral approval form shall be filled in. The doctor in charge puts forward the reasons for referral, the section chief puts forward the referral opinions, which are reviewed by the medical insurance office of the medical institution and signed by the dean in charge. Referral must be reported to the municipal medical insurance center for approval before it can be carried out.
2 in principle, the referral should be from the city to the outside, from the province to the outside. City referral should be carried out between designated medical institutions. The referral outside the city is put forward by the designated medical institutions above grade three in the city.
3. The medical expenses incurred after the referral of the insured shall be paid in cash by the individual or unit. After the medical treatment, the insured or his agent shall submit the referral approval form, medical record certificate, prescription and valid documents to the medical insurance institution, and reimburse all hospitalization expenses within the scope paid by the fund.