At present, most of the medical insurance is implemented at the local and municipal level, and in order to realize the direct settlement of personal accounts in different places within the province, it is necessary to rely on the support of the provincial platform for data transmission. However, in the current situation, the degree of advancement of each province is not consistent. Some places first opened a hospitalization and outpatient special diseases of the part of the hospital direct settlement, while the pharmacy direct settlement of the other side of the start is very late.
Definition of medical insurance card:
Social medical insurance card (referred to as medical insurance card or medical insurance card) is a special card for the medical insurance personal account, which uses personal ID card as the identification code, storing and recording the personal ID card number, name, gender, and the account of the allocation of funds, consumption and other detailed information.
Medicare cards are generally organized by local designated agent banks and are a type of multi-functional debit card. After the insured unit pays its contributions, the local health insurance business unit will entrust the bank to disburse the portion of the individual account fund to the insured employee's personal health insurance card at the end of the month.
Characteristics of medical insurance:
With the characteristics of "low level and wide coverage", the contribution is based on the low level of the majority of units and individuals can afford, and widely covers all units and workers in cities and towns, so that workers in units of different natures are able to enjoy the right to basic medical insurance. Participants can enjoy the right to basic medical insurance for the rest of their lives once they have completed their contribution period. Secondly, basic medical insurance is characterized by the "two sides of the burden, combined with the unified account"; the "income to determine expenditure, revenue and expenditure balance" as the principle.
The benefits are based on uniform standards. The same conditions of access, the same charges, the same treatment, there is no difference between high and low. Employees' outpatient expenses can be deducted from their personal accounts, and after the deduction, the employees will pay by themselves. Employees' hospitalization expenses are reimbursed on a pro rata basis: 86% for 10,000 RMB expenses by tertiary hospitals; 88% for 10,000 to 20,000 RMB expenses by tertiary hospitals; and 92% for 20,000 to 40,000 RMB expenses by tertiary hospitals. If the employee does not get sick for several years in a row the personal account funds can be accumulated and rolled over.