Medical expenses such as seeing a doctor, taking medicine, hospitalization and operation can be reimbursed by medical insurance card according to relevant regulations.
The medical insurance card does not pay for the scope of medical treatment projects:
(1) service items
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for name calling operation, high quality and good price, and special care by oneself.
(2) Non-disease treatment projects
1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;
2. Various weight loss, weight gain and height increase projects;
3. Various health checks;
4, all kinds of prevention and health care projects;
Personal account payment scope of medical insurance card:
1, specific medical expenses of the insured, including outpatient expenses incurred by designated medical institutions;
2. Drug purchase expenditure of designated retail pharmacies;
3, the basic medical expenses of designated hospitals and outpatient clinics for specific projects, and the expenses below the Qifubiaozhun as a whole;
4, more than Qifubiaozhun should be borne by the individual. ?
The insured person's use of personal account funds to pay medical expenses shall conform to the provisions of the scope of basic medical drugs, the scope of diagnosis and treatment projects, the scope of medical service facilities and payment standards.
Extended data
Medical insurance base
Medical insurance takes the base as the unit, and the unit pays 10%, and the individual pays 2%. All individuals enter the card, and the unit pays about 1% into the medical insurance card. 1 1% of the monthly salary, including 9% for the unit and 2% for the individual. What is credited to your personal account is a 3% handling fee of 1 1%.
Calculation method of the amount in medical insurance card
Medical insurance for employees is charged at 8% of individual salary, of which 2% is paid by individuals and 6% by units. The money on the medical insurance card consists of two parts:
1. On-the-job: over 45 years old 1, and 2% paid by the individual is credited to the personal account; 2.65,438+0.4% was transferred to personal account from 8% of the company; And 3.4% of the monthly salary is credited.
2. 1 and 2% paid by individuals under the age of 45 are all transferred to personal accounts. 2. From the company's 8%, 1.2% is transferred to personal account. 1 * * is 3.2% of the monthly salary. Retirees do not pay fees. The monthly salary is 3.9%.
Method for use medical insurance card in hospital
1. When a person with a medical insurance card sees a doctor in a designated hospital, he can use the medical insurance card to swipe his card directly on the POS machine, and pay the medical treatment fee and medicine fee without hospitalization. Pay attention to the window designated by medical insurance, and the medical insurance card cannot be used for cash withdrawal or transfer.
2. If a medical insurance patient is hospitalized in a designated medical insurance hospital, he can issue a medical insurance card, and the medical insurance unified settlement system will read the information of the insured person and handle the hospitalization number. At the time of discharge settlement, the medical insurance system will not accept the part that you should reimburse (that is, part of it has been reimbursed). The specific reimbursement ratio varies from place to place. Generally speaking, according to the actual amount of expenditure, for example, the proportion of reimbursement for spending 10 thousand is about 55%-65%.
3. In general medical insurance designated pharmacies, you can use the medical insurance card to pay directly.
4. The medical insurance card is used in the designated medical insurance hospitals registered in real-name registration system. Only I can use it, and no one else can borrow it.
The new medical insurance card can only be used when the funds are available. Therefore, before using the medical insurance card, check the balance in the card first. The minimum medical insurance card is about one month in 40 yuan. The higher the medical insurance premium, the more money there is in the card.
Refer to Baidu Encyclopedia-Medical Insurance Reimbursement Ratio
Refer to Baidu Encyclopedia-Medical Insurance Reimbursement Scope
Refer to Baidu Encyclopedia-Medical Insurance Personal Account