Q: Isn't the outpatient registration fee reimbursed in proportion? A: From June 1 2009, the outpatient treatment fee will be paid to 2 yuan by the medical insurance fund, and the rest will be paid by the insured in cash. It is worth noting that regardless of whether the medical expenses incurred by patients this year exceed the outpatient deductible line, the medical insurance fund will also pay 2 yuan a fixed amount. Q: Are the medical expenses of purchased drugs settled by credit card in real time? Answer: The original settlement method is still adopted for medical expenses incurred due to drug purchase, instead of real-time credit card settlement. Q: Under what special circumstances can the insured get full cash reimbursement for medical expenses? Answer: In case of emergency without social security card, family planning operation, enterprise arrears, manual reimbursement or replacement of social security card, and failure to issue social security card after enrollment, medical expenses will still be paid in full by the insured person's personal cash, so it is impossible to complete real-time settlement directly in the hospital. In line with the medical insurance fund payment conditions, according to the original process for manual reimbursement procedures. [1] Q: How to read the real-time settlement bill? A: In the bill details of real-time settlement, the amount within the scope of medical insurance can be included in the total expenses paid by medical insurance. This medical insurance fund payment: the total amount of expenses that should be paid by the medical insurance fund according to the policy, including large outpatient medical treatment, supplementary insurance for retirees and subsidies for disabled soldiers. The medical expenses "borne by this individual" include three parts: 1, self-payment 1: the medical expenses that should be borne by the individual in proportion (including the amount above the deductible line and above the cap line); 2. Out-of-pocket 2: the amount that needs to be borne by individuals in the Category B catalogue (such as the medical expenses paid by individuals for Category B drugs10%); 3. Self-expense: medical expenses beyond the scope of reimbursement (i.e. drugs, diagnosis and treatment, service facilities); The total medical expenses of this medical treatment = this medical insurance fund payment+this personal burden. Q: How should retirees change their social security card information? A: The cardholder information can be synchronized with the social security institutions in the districts and counties where the card issuing unit is located. Q: What will happen if retirees fail to change their social security card information in time? A: Employees who do not change their information in time after retirement are still reimbursed according to the deductible line and reimbursement ratio of the outpatient service, which may damage the medical insurance rights and interests of the insured. Q: Do I need to choose a hospital card for medical treatment? A: After the implementation of card-holding medical treatment, the designated medical institutions for individual medical treatment are still subject to the designated medical institutions selected in the medical insurance manual, and Class A, Chinese medicine and specialist hospitals can directly seek medical treatment. Q: Is there any change in the deductible of social security card participants? Answer: The payment standard remains the same after the card is used for medical treatment: only one deductible line is deducted from the outpatient (emergency) consultation expenses of the insured within one year: employee 1.800 yuan, retiree 1.300 yuan. According to the policy, the medical expenses below the outpatient deductible line shall be paid by the personal account fund. For the part exceeding the deductible, according to the reimbursement ratio stipulated by the policy, the individual only bears the medical expenses that should be paid by himself. Q: What adjustments have been made to the personal account management policy after holding a card for medical treatment? A: At present, the personal account management policy has not been adjusted. After holding the card for medical treatment, the amount of the insured's personal account is still transferred to the insured's special passbook for medical insurance in Bank of Beijing on a monthly basis, and the personal account funds can still be withdrawn independently in the bank. Q: The insured who has received the social security card has accidentally lost the medical insurance manual (blueprint). What should I do? I lost my social security card. How can I reissue it? Answer: You need to go to the county social security center of the insured area to go through the formalities of completing the medical insurance manual (blueprint). When you reissue the medical insurance manual (blueprint), you need to provide the cardholder's social security card, and the county social security center will update the card information of the social security card for you. If the social security card is lost, you need to go to the county-level social security center in the insured area to go through the formalities of replacement. The unit should also provide the medical insurance manual (blueprint) of the insured, and the county social security center will update the information in the social security card for them simultaneously. Q: Where can I get the social security card? A: On-the-job personnel receive the card at the insured unit; Retirees receive cards from the original insured units; Socialized management of retirees in the insured street social security office to receive; Employment agencies and talent archivists obtain certificates at employment agencies and talent service centers in the insured areas. Q: After receiving the card, I found that the information in the card was wrong. How to change it? A: Most of the cases found are that the photos don't match me, or the names are pronounced differently. In any of the above circumstances, the cardholder shall return the social security card to the district social security center through the unit. Q: What should I do if the received social security card and ID card information are inconsistent? Answer: Give the copy of the social security card and ID card or household registration book to the unit, and the unit will give it to the county social security center for re-business card printing. Q: How to view the information in the card? A: You can take your card to the card service outlets for help, or you can pick it up on the electronic touch screen of the self-service terminal for self-inquiry. At present, the social security card service system in this city mainly consists of four parts: social security card service outlets, social security card service hotlines, social security card service websites and social security card self-service terminals. Set up social security card service outlets in more than 300 street social security offices, 18 district and county social security centers and the social security center of the Economic Development Zone of the city to facilitate cardholders to handle social security card-related business; The social security card service hotline is "",providing 24-hour service; In addition, logging in to Beijing Human Resources and Social Security Network 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 in this city, which can realize the functions of medical insurance information inquiry and pre-loss reporting. Q: Why do some employees have cards and some don't? A: The social security card issued this time is the time information at 0: 00 on February 16, 2009 in the medical insurance database. After that, new insured persons and those who need to collect secondary information due to incorrect information comparison are not included in the scope of this card issuance. In this way, some employees in the unit have cards and some don't. Q: After the insured person receives the card, how to determine the time for holding the card for medical treatment? Why do some units inform the insured that they can only use social security cards for medical settlement in the second half of the year or during the year? Answer: After receiving the social security card, the insured person can go to the designated medical institution for medical treatment and settle the account in real time. But before that, if there are medical expenses paid in full by individuals, manual reimbursement procedures should be handled in advance. Q: Do the insured who have received the social security card continue to use the medical insurance manual (blueprint) in their hands? A: Social security cards in this city will be issued in stages. Before the social security card completely replaces the medical insurance manual (blueprint), the social security card will be used in parallel with the medical insurance manual (blueprint). When the medical insurance manual (blueprint) stops being used, a notice will be issued to inform the whole city. Q: What if I forgot to bring my card this time? Answer: Insured persons who have received social security cards must show their social security cards when seeking medical treatment in designated medical institutions that have opened card-based medical settlement services. If the social security card is not presented, the expenses incurred shall be borne by the individual in full, and the medical insurance fund cannot pay it. Q: How do the insured who uses the social security card for the first time handle the card opening procedures? Answer: The insured person goes to the designated medical institution for medical treatment with the social security card, and can open the social security card at the same time of registration or payment. Q: How do I use my social security card to see a doctor? A: First of all, you must show your social security card when registering, and pay your own expenses in cash. The hospital will issue a bill for the insured. Secondly, when going to the clinic to see a doctor, you should take the initiative to show your social security card and the Handbook of Emergency Medical Records of Medical Institutions in Beijing; Third, when paying fees, the social security card and payment documents must be handed over to the settlement personnel to pay part of the expenses paid by individuals and at their own expense; Finally, after getting the settlement documents, carefully check the contents of the documents and recover the social security card. Q: Is the unified supplementary medical insurance for retirees paid by credit card at the same time? A: Yes. Q: How can I see a doctor during the replacement (replacement) of my social security card? Answer: During the period of applying for the replacement (replacement) of social security card, the insured should take the initiative to show the certificate of the new development (replacement) of social security card when going to the designated medical institution for medical treatment. Designated medical institutions collect relevant information according to the vouchers of new cards and reissued social security cards, and upload the details of expenses. When the designated medical institutions settle medical expenses for the insured, they will collect cash in full and issue relevant documents, and the insured will declare medical expenses according to the original process with a new social security card. Q: How do cardholders go to designated medical institutions that do not have the conditions to swipe their cards? A: Cardholders must pay in full cash when they go to designated medical institutions that do not have the conditions to swipe their cards. The hospital will issue a receipt for medical expenses for the insured and upload the details of medical expenses. The insured shall reimburse the outpatient medical expenses according to the original process with the social security card. Q: After an industrial accident, how to distinguish whether social security cards should be used for real-time settlement? If it is settled in real time and then identified as a work-related injury, how to solve it? Answer: If it is really an industrial accident, the medical expenses should be paid in full, and then reimbursed through industrial injury insurance; If it is settled in real time and then identified as a work-related injury, the insured will refund the real-time settlement fee and then pay the medical expenses in full. After that, the medical expenses paid in full will be reported to the county medical insurance agency for manual reimbursement. Q: Under what circumstances do I need to change my social security card information? A: (1) Medical insurance is transferred from working to retirement; (2) disabled soldiers who is newly insured; (3) changing the coverage of medical insurance; (4) Examination and approval of special diseases. (5) The manual is lost and replaced. Q: What should I do if I lose my social security card? Answer: After the cardholder loses his social security card, he can call the social security card service hotline (24-hour service) to report the loss in advance. You can also go through the written pre-loss reporting procedures at the social security card service outlets with your resident ID card or household registration book, or directly report the loss at the self-service terminals set up at the social security card service outlets and designated medical institutions above the second level. The effective time of pre-loss reporting is 10 day, and it will be automatically released after the effective time limit. If the loss-reporting person determines that the lost social security card cannot be recovered, he/she needs to hold his/her resident ID card to report the loss to the social security card service outlets formally, and at the same time, he/she should go through the formalities of replacing the card. 15 working days later, the applicant will receive the social security card at the social security card service outlet with his/her resident ID card or household registration book and the Certificate of New Social Security Card Replacement (hereinafter referred to as the Certificate of Getting the Card, see Annex 1). After the formal loss reporting, the loss reporting cannot be cancelled.