1. The balance in the employee's medical insurance card is mainly used when the employee is sick and needs to see a doctor or take medicine. It can be an outpatient or an inpatient;
2. If you have a physical examination, you need to see your hospital. If the hospital where the employee has a medical examination has medical insurance qualification, it can be reimbursed.
The following items are not included in the scope of medical insurance reimbursement:
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, expedited fees for examination and treatment, additional fees for roll-call surgery, high-quality and low-cost fees, and self-invited special care;
3. Various cosmetic, bodybuilding and non-functional cosmetic plastic surgery;
4, all kinds of weight loss, weight gain, increase the project;
5. Various health checks;
6, all kinds of prevention and health care projects;
7, all kinds of medical consultation, medical appraisal;
8, the application of positron emission tomography scanner, electron beam C, ophthalmic excimer laser therapeutic equipment and other large medical equipment for inspection and treatment projects;
9, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment;
10, all kinds of self-use health care, massage, examination and treatment equipment;
1 1, a one-time medical expense that cannot be charged separately as stipulated by the provincial price department.
To sum up, under normal circumstances, social security cards cannot be used for physical examination. Items that are not within the scope of medical insurance reimbursement, such as registration fees, out-of-hospital consultation fees, medical records and other consultation fees, urgent examination and treatment fees, roll-call surcharges, high-quality and low-price fees, self-invited special care and other special medical services.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 27 of People's Republic of China (PRC) Social Insurance Law
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; 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.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.