First, the adjustment of medical insurance policy
The medical insurance policy may be adjusted with time and different regions, which sometimes leads to the inability to use medical insurance for certain drugs or services in the insured areas. Insured personnel should pay close attention to the changes of medical insurance policy in time and obtain the latest medical insurance policy information.
Second, the issue of personal accounts.
Medical insurance personal account may be abnormal due to various reasons, such as insufficient balance and incorrect information, which leads to the inability to use medical insurance. The insured person can check the personal account information, confirm whether there are problems and deal with them in time.
Third, medical institutions are not connected to the Internet.
Some medical institutions may not be connected to the medical insurance system for technical or other reasons and cannot use medical insurance to settle accounts. When choosing a medical institution, the insured should pay attention to confirm whether the institution supports medical insurance settlement.
Four, did not use medical insurance according to the prescribed procedures.
The insured should follow certain procedures and regulations when using medical insurance. Failure to follow the prescribed procedures may result in failure to obtain medical insurance. Insured personnel should understand and abide by the regulations on the use of medical insurance to ensure the normal use of medical insurance.
To sum up:
Medical insurance cannot be used in the insured place, which may be due to the adjustment of medical insurance policy, personal account problems, medical institutions not connected to the internet or not using medical insurance according to the prescribed procedures. Insured persons should pay attention to the changes of medical insurance policies, inquire about personal account information, choose medical institutions that support medical insurance settlement, abide by the provisions on the use of medical insurance, and ensure the normal use of medical insurance.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
People's Republic of China (PRC) social insurance law
Article 3 1 stipulates that:
According to the needs of management services, social insurance agencies can sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.
Medical institutions shall provide reasonable and necessary medical services for the insured.
People's Republic of China (PRC) social insurance law
Article 88 provides that:
Whoever defrauds social insurance benefits by fraud, forgery of certification materials or other means shall be ordered by the social insurance administrative department to return the defrauded social insurance benefits, and a fine of not less than two times but not more than five times the amount defrauded shall be imposed.