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Card usage is as follows:
1, Social security card (health insurance) (hereinafter referred to as the card) is for the sole use of the insured, and may not be lent, fraudulent, altered or forged.
2. The card should be kept in a safe place and should not be bent, folded, scratched or touched with magnetic objects (e.g., televisions, stereos, magnetic clasps, etc.).
3, participants to the city designated hospitals for medical treatment, to the designated pharmacy dispensing (excluding social security card), you must hold a medical insurance card (social security card by the participants who have been issued social security card use). Life Insurance active employees), or in the city, district or county medical insurance center for medical expenses reimbursement and other medical insurance affairs.
4. If the medical insurance card is not visibly damaged but cannot be used, the participant can go to the nearest city, district or county medical insurance center to replace the card.
5. When the medical insurance card cannot be used in a designated hospital or pharmacy due to equipment failure, the medical expenses shall be paid by the individual in cash first. After troubleshooting, equipment failure should be resettled in the original hospital or pharmacy in accordance with regulations.
6. When an insured person working abroad settles abroad or cancels his/her household registration, the relationship between the medical insurance and the insured person will be stifled. The medical insurance card should be returned to the city, district or county medical insurance center for cancellation.
How insured employees can seek medical treatment and pay for medical expenses according to the regulations:
1. First of all, insured persons should go to the designated medical institutions for basic medical insurance to seek medical treatment and purchase medicines, or they can hang up prescriptions and go to the designated medical institutions to purchase medicines from retail pharmacies. Medical expenses incurred for medical treatment at non-designated medical institutions and purchase of medicines at non-designated pharmacies shall not be paid except
Basic medical insurance fund is eligible for referral and other prescribed conditions.
2. Secondly, the medical expenses incurred must be in line with the drug catalog, diagnostic and therapeutic items and medical services of the basic medical insurance.
Medical expenses within the scope of the facility standards and payment standards can be paid by basic medical insurance in accordance with the regulations. Exceeding
part of the basic medical insurance is not paid in accordance with the provisions of the basic medical insurance.
3. Medical expenses in line with the scope of payment of basic medical insurance are paid by the integrated fund. The scope of payment still belongs to the individual account payment range. Medical expenses belonging to the scope of payment of the integrated fund, that is, belonging to the integrated fund more than the minimum payment standard of the fund-raising costs, the integrated fund to pay a proportion of the "ceiling" as a limit. Individual medical expenses are also borne by the individual, and all expenses above the "ceiling" are paid by the individual or through participation in supplementary medical insurance. Medical insurance, commercial medical insurance, etc. Medical expenses below the starting standard will be settled by the individual account, and if there is a balance in the individual account, part of the medical expenses to be paid by the individual can also be paid within the scope of the integrated fund. Assumptions: the employee goes to the designated designated medical institution within one year, consults, and incurs medical malpractice costs of 200 yuan; two hospitalizations incur medical costs of 20,000 yuan and 10,000 yuan, of which the two hospitalizations are divided into two parts not exceeding 2,000 yuan and 1,000 yuan of the basic medical insurance drug catalog and diagnostic and therapeutic items; the scope of the payment of the local account is divided into outpatient and inpatient. The first hospitalization down payment standard for the first 800 yuan, the second 500 yuan financing the scope of the cost of payment ratio of 90%, the maximum payment limit of 20,000 yuan.
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