The reasons for the unknown error in medical insurance payment are as follows:
1. It may be due to the abnormal status of the medical insurance card;
2. Or there is no regular payment for a long time;
3. Secondly, the medical insurance card identification device in the hospital has failed.
medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the payment of employers and individuals. After the insured person suffers from medical expenses, the medical insurance institution will give him some economic compensation.
The reimbursement conditions of medical insurance are as follows:
1. The insured must go to the designated medical institutions of basic medical insurance for medical treatment and purchase medicines, or purchase medicines from designated retail pharmacies determined by social insurance institutions with medical prescriptions issued by doctors in designated hospitals;
2. The medical expenses incurred by the insured in the process of seeing a doctor must conform to the scope and payment standards of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, before they can be paid by the basic medical insurance fund according to regulations;
3. among the medical expenses that the insured meets the payment scope of the basic medical insurance, the part above the threshold and below the maximum payment limit of the social medical pooling fund shall be paid by the social medical pooling fund in a unified proportion.
legal basis
social insurance law of the people's Republic of China
article 23 employees shall participate in basic medical insurance for employees, and the employer and employees shall pay the basic medical insurance premiums in accordance with the state regulations.
individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employing unit and other flexible employees can participate in the basic medical insurance for employees, and individuals will pay the basic medical insurance premium according to state regulations. Article 25 The state establishes and improves the basic medical insurance system for urban residents.
the basic medical insurance for urban residents combines individual contributions with government subsidies.
people who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people over 6 years old and minors from low-income families, etc. will be subsidized by the government.