Specifically, if a resident has been enrolled in the health insurance program and has paid health insurance premiums for 15 years or more, he or she will be entitled to basic health insurance benefits for life, and will no longer need to continue to pay health insurance premiums. It should be noted that 15 years refers to the cumulative number of years of contributions, and does not require continuous contributions.
Medicare policies may vary from region to region, depending on local policies. Meanwhile, although you can enjoy the basic medical insurance benefits for life, you may need to bear part of the cost for some high-end medical services and medicines. Therefore, when it comes to enjoying health insurance benefits, it is also necessary to make reasonable choices and plan according to the specific situation.
The process of using the medical insurance card is generally as follows:
1. Apply for the medical insurance card: Those who hold a social security card or an electronic voucher for medical insurance can go to the local social security or medical insurance management organization to apply for a medical insurance card. You need to provide ID card, social security card or health insurance electronic voucher and other documents and information, pay a certain amount of card fees, and then wait for the completion of the health insurance card;
2, query health insurance information before seeking medical treatment: before seeking medical treatment, you can query your own health insurance information through the health insurance card query terminals, health insurance APPs and other means, including basic personal information, type of health insurance, reimbursement rate, balance, etc.
3, holders of health insurance card: you can go to the local social security or health insurance management organization to apply for a health insurance card. p>
3. Cardholders need to present their medical insurance cards when seeking medical treatment at a medical institution, and the medical institution will read the information on the card through a card reader to determine whether the card is valid and can be used. It is important to note that the medical insurance card can only be used in the specified medical institutions and medical services, or else reimbursement will not be possible;
4. Settlement of medical insurance: After the completion of the medical treatment, the medical institution will record the cost of the medical treatment into the electronic settlement system and upload the information of medical treatment to the medical insurance center through the medical insurance card reader to carry out the settlement of the cost. The medical insurance center calculates the expenses that should be reimbursed according to the medical insurance policy and individual contributions, and credits the reimbursed portion of the expenses to the cardholder's medical insurance account.
In summary, the process of using a health insurance card may vary from region to region, and you can consult with your local health insurance management organization or relevant departments for specific procedures and policies. In addition, cardholders should comply with health insurance policies and regulations when using their cards, pay attention to the choice of medical treatment, and avoid irregularities and medical fraud.
Legal basis:
Article 26 of the Social Insurance Law of the People's Republic of China
The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the state regulations.
Article 28
Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergencies and salvages, shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 29
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.
Article 30
The following medical expenses shall not be included in the scope of payment by the basic medical insurance fund:
(1) those that should be paid from the Workers' Compensation Insurance Fund;
(2) those that should be borne by a third person;
(3) those that should be borne by the public ****health;
(4) those that seek medical treatment outside of China.