Social insurance provides basic living security for workers. Workers can enjoy social insurance benefits as long as they meet the conditions for enjoying social insurance, that is, they have established labor relations with employers or paid various social insurance premiums according to regulations. The following is how I can't pay the second grade of social security in a third-class hospital, hoping to help everyone.
Why can't I pay the second social security file in the top three hospitals for reimbursement?
Because I went straight to the hospital. Second-level social security needs to see social health first, and then be referred to the hospital for reimbursement.
Extended materials: Why should the second and third grades of basic medical insurance be bound to a community health center for outpatient service of the insured?
Answer: The second file of basic medical insurance is basically paid at 0.7% of the average monthly salary of employees in this city in the previous year, of which the employer pays 0.5% and the individual pays 0.2%; The third grade medical insurance is paid monthly at 0.5% of the average monthly salary of employees in this city in the previous year, of which 0.4% is paid by the employer and 0. 1% by the individual. In order to maintain the balance of the overall fund on the basis of low payment, there must be a supporting mechanism, that is, the outpatient service must be bound to the nearest community health center and the outpatient service quota system must be implemented. The monthly insurance premium paid by each person shall be included in the community outpatient co-ordination fund according to 0.2% of the average monthly salary of employees in this city last year for outpatient co-ordination. According to the number of insured persons bound to the settlement hospital, the social security agency allocates a quota to the settlement hospital every month, which is managed by the hospital as a whole and independently controlled, and is responsible for the settlement of medical expenses for workers' outpatient clinics bound to their subordinate social health clinics every month. The purpose of implementing the contract responsibility system is to let designated medical institutions participate in fund management, control the fund reasonably, reduce the waste of medical resources such as over-examination and over-treatment, improve the efficiency of fund use, and then reduce the management cost. At the same time, outpatient co-ordination overcomes the shortcoming that personal accounts have no economic benefits, realizes the co-ordination of community outpatient funds, and guarantees outpatient and hospitalization at a lower cost.
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