The National Drug Catalogue of Basic Medical Insurance divides drugs into three categories: the first category A, which can all enter the scope of medical insurance reimbursement and be reimbursed according to the proportion of medical insurance; The second category B, the use of such drugs requires individuals to bear part of the expenses according to a certain proportion, and the rest will enter the scope of medical insurance reimbursement and be reimbursed according to the proportion of medical insurance; Class III and Class C, these drugs are not reimbursed, and all of them are borne by individuals.
First, the scope of use of medical insurance card
1. Buy medicine
The insured can use the funds in the medical insurance card to buy drugs (quasi-brand drugs and Chinese herbal pieces), medical devices (food and drug supervision machinery, drug supervision machinery) and disinfection products (health disinfection) in designated retail stores.
When using medical insurance cards in designated pharmacies, relevant signs will be posted in more conspicuous places. Calcium tablets, cotton wool, disinfectant alcohol, etc. Old people and children at home often take it, and they can buy it with a medical insurance card.
Note: the purchase amount of medical insurance card is less than 200 every half month.
see a doctor
The insured in the designated medical institutions outpatient (emergency) consultation (excluding outpatient special diseases and diagnosis and treatment projects) below the overall Qifubiaozhun medical expenses; Individuals above the Qifubiaozhun and below the maximum payment limit bear a certain proportion of medical expenses.
3. Help relatives pay medical insurance premiums
After signing the payment agreement with the medical insurance management center, the insured can use the personal account funds of the medical insurance card to pay the basic medical insurance premium for urban residents for their relatives (limited to two people and below).
Step 4 have a physical examination
The insured can use personal accounts to settle the health examination fees of designated medical institutions below the municipal level (including the municipal level).
Second, the method of use
1, scope of use of medical insurance card: When insured employees buy medicines in designated hospitals and pharmacies, they can swipe their cards on POS machines with their passwords, but they cannot withdraw cash or transfer money.
2. Inquire about the balance of medical insurance card: Insured employees can call 95566 to inquire about the balance, or they can inquire at the Bank Savings Office of China or the designated hospitals and pharmacies in the urban area.
3. Inquiry on medical insurance card transactions: Insured employees can print medical insurance card transaction records, including personal account payment records and consumption records, at BOC-BOC Savings Office. If you have any questions about the transaction records, you can go to the retail business department of Bank of China-Bank of China.
4. Medical insurance card password: If the insured employee changes his password, he can dial 95566 to change it, or he can bring his ID card to the Bank of China Savings Office to change it. If the insured employee forgets the password, he can bring his ID card to the Bank of China Savings Office to report the loss of the original password and change it.
5. Custody of medical insurance card: Insured employees should keep the medical insurance card properly. If you accidentally lose it, please immediately issue a letter of proof to the unit and stamp it at the medical insurance office for confirmation, and then report the loss to China Bank Savings Office with your ID card and go through the formalities of replacement. After 7 days, they can get a new card.
6. Precautions: When the number of medical insurance card transactions reaches 60 times, the insured employees must go to China Bank Savings Office to print the transaction records, otherwise they will stop using the card. After the transaction record is printed, the card can continue to be used.
legal ground
People's Republic of China (PRC) social insurance law
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.