First, the role of the social security card: cardholders can use the card for medical treatment, medical insurance personal account settlement; can use the card for old age insurance affairs; can use the card to the relevant departments for job-seeking registration and unemployment registration formalities, unemployment insurance benefits, apply for employment training; can use the card to apply for labor certification and apply for labor injury insurance benefits. The card can be used to apply for labor capacity appraisal and to apply for labor injury insurance treatment.
Second, hospitalization reimbursement: 1, hospitalization starting standard: third-level hospitals, including those above the third level: 700 yuan within a year, multiple hospitalization starting payment of 500 yuan, 400 yuan, 300 yuan in that order. 2, the second level including the second level of specialized hospitals: 600 yuan within a year of multiple hospitalization starting payment in order of 400 yuan, 300 yuan, 200 yuan.
3, the first level including the following hospitals: 500 yuan within a year multiple hospitalization starting payment in order of 300 yuan, 200 yuan, 100 yuan.
Expanded Information:
The social security card is an electronic voucher for workers in the field of labor security. Cardholders can use the card to seek medical treatment and settle their medical insurance accounts; they can use the card to apply for pension insurance; they can use the card to register for job-seeking and unemployment, apply for unemployment insurance benefits, and apply for employment training; and they can use the card to apply for labor capacity appraisal and to apply for work-related injury insurance benefits, and so on.
In addition, the social security card is also held in the hands of the workers to open the door to contact with the system, with this key, the cardholder can query the information on the Internet, and in the future, you can also be on the Internet to handle the relevant labor and social security affairs.
References:
I social security card down,
Take the unit issued by the social security card to the hospital to see the reimbursement, the specific process is as follows: 1, first of all the participants to go to the doctor, take the social security card to the registration office to register.
2, the insured person to take the registration form to the consultation room to see a doctor, the doctor to the insured person to see the doctor, will open a prescription to pay the fee. 3, the insured person to take the prescription to the hospital settlement window price, directly brush the social security card to pay for the medical expenses of the medical insurance fund.
4. If some of the drugs in the prescription are not covered by the medical insurance fund, the insured person needs to pay cash out of pocket. According to Article 30 of the Social Insurance Law, the following medical expenses are not included in the scope of payment of the basic medical insurance fund: (1) those that should be paid from the industrial injury insurance fund.
According to Article 64 of the Social Insurance Law, which stipulates that "each social insurance fund shall keep separate accounts in accordance with the type of social insurance, and shall be accounted for separately", the medical expenses that should be paid from the Industrial Injury Insurance Fund cannot be included in the scope of payment of the Basic Medical Insurance Fund. (2) should be borne by a third party.
The medical expenses incurred by the insured as a result of personal injury caused by a third party shall be borne by the third party. (3) should be borne by the public **** health.
The basic public **** health services are provided free of charge to urban and rural residents on a project-by-project basis, and the funding standard is approved according to the comprehensive cost of the unit service, and the required funds are arranged by the *** budget. (4) medical treatment outside the country.
The medical costs of overseas medical treatment are not included in the scope of payment of the basic medical insurance fund.
Take the unit issued by the social security card to the hospital to see how to reimbursement
First of all, the participants go to see a doctor, take the social security people to see the doctor, are open a prescription payment.
The participant takes the registration form to the consultation department to see the doctor, the doctor gives the participant card to go to the registration office. After taking the prescription to the hospital's billing window, the participant directly swipes the social security card to pay for the medical expenses covered by the medical insurance fund.
If there are medicines in the prescription that are not covered by the medical insurance fund, the participant has to pay cash out of pocket.
Expanded information:
After getting medical insurance, if you are an active employee, you can only be reimbursed for medical expenses above 1800 RMB after visiting the outpatient or emergency clinic of a hospital, and the reimbursement rate is 50%. If you are a retiree under the age of 70, you can be reimbursed for expenses over 1,300 yuan, and the reimbursement rate is 70%.
In the case of retirees over the age of 70, expenses over $1,300 can be reimbursed the reimbursement rate is 80%. And no matter which category of people, the maximum limit for outpatient and emergency large medical expenses paid is 20,000 yuan.
For example, if you are an active employee and the cost of an outpatient visit is $2,500, the $700 portion can be reimbursed at 50%, which is $350. In the case of hospitalization expenses, the starting amount is $1,300 for the first time you use basic medical insurance to pay in a year in 2009, whether you are an active employee or a retiree.
And for the second and subsequent hospitalization medical expenses, the starting amount is determined at 50%, which is 650 RMB. And the maximum payment amount of the basic medical insurance fund (hospitalization expenses) is 70,000 RMB in 1 year.
The standard of hospitalization reimbursement is related to the level of the hospital where the insured person lives, such as living in a tertiary hospital, from the starting standard to 30,000 yuan of expenses, the employee pays 15%, that is, 85% reimbursement; 30,000 yuan to 40,000 yuan of expenses, the employee pays 10%, reimbursement of 90%; more than 40,000 yuan to the maximum payment limit of the portion of the cost, then 95% of the cost of the reimbursement, the employee only needs to pay 5%. And retirees personally pay 60% of the percentage of active (that is, the aforementioned) employees, but below the starting standard, all paid by the individual.
Employee basic medical insurance does not pay for the cost of diagnostic and treatment items are mainly non-clinically necessary, the effect of uncertain diagnostic and treatment items as well as special medical services diagnostic and treatment items, including services such as registration fees, non-disease treatment items such as cosmetic surgery, therapeutic equipment and medical materials such as hearing aids and other therapeutic items such as magnetic therapy and other categories such as infertility treatments, etc. In accordance with the "national basic medical insurance diagnostic and treatment items", the employee will be reimbursed for the cost of diagnostic and treatment items. In accordance with the "National Basic Medical Insurance Diagnostic and Treatment Program Scope", as follows: (a) service category.
(1) registration fees, out-of-hospital consultation fees, medical record cost, etc.; (2) consultation fees, examination and treatment of expedited fees, name surgery surcharge, quality premium fees, self-invited special nurses and other special medical services. (B) non-disease treatment program category.
(1) a variety of beauty, fitness items and non-functional cosmetic, orthopedic surgery, etc.; (2) a variety of weight loss, weight gain, height projects; (3) a variety of health checkups; (4) a variety of preventive, health care diagnostic and treatment programs; (5) a variety of medical consultation, medical appraisal. (C) diagnosis and treatment equipment and medical materials.
(1) the application of positron emission tomography device (PET), electron beam cT, ophthalmic excimer laser therapy instrument and other large medical equipment for examination and treatment programs; (2) glasses, dentures, prosthetic eyes, prosthetics, hearing aids and other rehabilitative appliances; (3) a variety of self-use of health care, ***, inspection and treatment equipment; (4) the price departments of the provinces can not be charged separately. disposable medical use. (D) treatment program category.
(1) all kinds of organ or tissue transplantation of organ or tissue source; (2) in addition to kidney, heart valves, cornea skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation; (3) myopic orthopedics; (4) qigong therapy, music therapy, health care nutritional therapy, magnetic therapy and other auxiliary therapeutic projects. (E) Other.
(1) a variety of infertility (pregnancy), sexual dysfunction diagnosis and treatment program; (2) a variety of scientific research, clinical verification of the diagnosis and treatment program.
References:
How do I get reimbursed for an outpatient visit if I have a social security card?
Just show your social security card.
When you show your social security card at the designated hospital to prove your identity and registration, you don't need to pay first and then reimbursement, you can directly settle the part of the social security reimbursement by the social security and the hospital, and only in the checkout, the part of the out-of-pocket payment by yourself with the balance of the social security card or cash. Detailed reimbursement regulations: Reimbursement scope: the insured person in the individual choice of health insurance designated hospitals or specialized hospitals, Chinese medicine hospitals and hospitals A class of general outpatient, emergency expenses.
Outpatient starting line: General outpatient and emergency expenses incurred in a natural year exceeding 1800 RMB in total. Reimbursement rate: 70% for hospitals and 90% for communities for the portion above 1800 RMB, and the ceiling line: 20,000 RMB.
Extended Information:
Cardholders can not only use the card for real-time settlement of medical insurance personal account, but also for pension insurance affairs; for job search registration and unemployment registration procedures; apply for unemployment insurance benefits; apply for employment training; apply for labor capacity appraisal and apply for enjoyment of work-related injury insurance benefits; and handle related labor and social security affairs on the Internet. The social security card adopts the unified national standard, and the social security number adopts the civil identity number in accordance with the relevant provisions of the Social Insurance Law.
References:
How to get reimbursed by the rural social security card
1. When you register for a consultation, you voluntarily show your social security card, and the registration fee is paid by the Medicare fund at a flat rate of two dollars, and you pay the rest yourself.
2. Show your social security card and medical record booklet when you visit the doctor, you should take the initiative to show them to the doctor and make sure that the medical record booklet is used continuously. 3, the settlement of the social security card, the reimbursement of part of the hospital advance, they only need to pay the part of the non-reimbursement, each unit of the insurance method is different, there is a kind of deduction of their own payroll more insurance method, medical treatment without the amount of the requirements, that is, all the medical insurance within the medical expenses can be reimbursed ninety percent, and there is a kind of only to reach the limited amount, only to reimbursement, and the rest of the cost of self-care.
: Farmers' social security card can enjoy the following services: 1, when the hospital card: farmers with social security card can be in the country's hospitals directly, the settlement of fees. 2, the drugstore card: the farmers can be in the country's hospitals, the settlement of fees. 2, the drugstore card with: in life there is inevitably a headache, some diseases such as colds, they can hold the social security card to go to the drugstore to brush medicine, convenient and money-saving.
3, when the bank card: social security card can be used as a bank debit card, which is embedded in the financial function, that is to say, the bank card can do things, social security card can be. 4, fitness consumption card: many areas of the country has been introduced to pilot "health insurance card fitness", the later should be fully promoted, to go to the gym can also be used inside the social security card money to offset consumption.
5, Citizen Card: Social security card can also be used as a citizen card, such as paying utility bills, buses and electronic wallet function. 6, subsidies issued by the card: whether it is agricultural subsidies or poverty alleviation subsidies or low income, pensions and so on will be directly into the farmer's social security card, no longer have to worry about problems in the intermediate links.
How much does the social security card reimburse for hospitalization
The social security card reimbursement rate for hospitalization is: 90% for first-class hospitals, 87% for second-class hospitals, 85% for third-class hospitals, and a total of 300,000 yuan for hospitalization.
Starting line for hospitalization: the starting standard for the first hospitalization in a natural year is 1,300 yuan, and 650 yuan for each subsequent hospitalization. Social security card hospitalization reimbursement scope: participants in the individual choice of health insurance designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and hospitals of category A hospitalization costs.
Social security card hospitalization reimbursement process: please use the "medical insurance manual", such as the unit to pay the full amount of fees, individuals only need to pay part of the hospitalization advance payment, you can go through the hospitalization procedures, the medical expenses incurred in line with the scope of medical insurance, the hospital and the individual when the hospital and the individual to clear the amount of out-of-pocket expenses, the amount of reimbursement of the integrated fund by the hospital and the district health insurance center settlement.
Expanded Information:
2. Outpatient starting line: the total amount of general outpatient and emergency expenses incurred in a natural year exceeds 1800 RMB. 3、Reimbursement ratio: 70% for hospitals and 90% for communities for the portion above 1800 RMB, and the ceiling line: 20,000 RMB.