Medical insurance means that through national legislation, basic medical insurance premiums should be paid in full and on time by employers and individual employees in accordance with the principle of compulsory social insurance.
If payment is not made in full and on time, the basic medical insurance pooling fund will not pay for medical expenses, regardless of personal account.
Reimbursement ratio range 1. Outpatient and emergency medical expenses: The accumulated medical expenses that meet the scope of basic medical insurance for active employees within the year (January 1st to December 31st) exceed 2,000 yuan.
2. Settlement ratio: During the contract period, 50% of the dispatched personnel’s expenses exceeding 2,000 yuan will be reimbursed, and the individual will pay 50%; the maximum amount of outpatient and emergency reimbursement paid to dispatched personnel in one year is 20,000 yuan.
3. Insured persons must properly keep the outpatient medical receipts (including receipts for large amounts and below, the bottom of prescriptions, etc.) for medical treatment at designated hospitals as proof of medical expense reimbursement.
4. Outpatient medical treatment for three special diseases: When the insured person needs to seek medical treatment in the outpatient clinic after taking radiotherapy and chemotherapy for malignant tumors, renal dialysis, and kidney transplantation, the second and third level designated medical centers for the insured person will be selected.
The hospital issues a "Disease Diagnosis Certificate" and fills out the "Medical Insurance Special Disease Application Approval Form" and reports it to the district medical insurance center for approval and filing.
Outpatient medical treatment and medicine collection for these three special diseases are only available in designated hospitals approved for treatment, and cannot be purchased at designated retail pharmacies.
If the medical expenses incurred fall within the prescribed range for outpatient special diseases, they will be settled with reference to hospitalization.
5. Inpatient medical treatment.
Only if you have paid enough medical insurance for 20 years can you enjoy medical insurance reimbursement after retirement.