Medical insurance cards are usually frozen due to failure to pay on time, so you only need to pay the outstanding fees.
If it is employee medical insurance, the health insurance card may be frozen because the unit did not pay premiums in time or paid too much in the last few days of the month.
If the unit pays the premium, it will be unfrozen, but it will take a certain number of working days from unfreezing to recovery. If hospitalization due to illness occurs during this process, the employee can come to the Medical Insurance Bureau for reimbursement with bank and local tax payment receipts after being discharged.
Extended information: "Regulations of the People's Republic of China and the National Basic Medical Insurance for Urban Employees" Article 31 The basic medical insurance fund pays part of the cost of diagnostic and treatment items and drugs in the Category B catalog. The proportion of personal out-of-pocket payment shall be determined by the Provincial People's Government
Sure.
Article 32: Medical expenses for Class A infectious diseases such as cholera and plague shall be fully paid from the overall fund.
The medical expenses for fulminant and epidemic infectious diseases confirmed by the health administrative department shall be settled by the people's government with special funds.
Article 38 The overall fund will not pay the medical expenses incurred by employees and retirees due to alcoholism, suicide, self-mutilation, illegal crimes, etc.
Medical expenses incurred due to traffic accidents, medical accidents, etc. shall be handled in accordance with relevant national regulations.
Settlement procedures (1) Settlement procedures for hospitalization and outpatient treatment of special diseases. Designated medical institutions shall submit the cost settlement statements, hospitalization settlement statements and relevant information of patients discharged last month to the medical insurance agency before the 10th of each month. The medical insurance agency shall
After review by the office, it will be used as the basis for monthly appropriations and year-end final accounts.
The medical insurance agency pre-allocates the overall cost of hospitalization and outpatient treatment for special diseases in the previous month every month.
Insured persons who are identified as suffering from special diseases should go to a designated medical institution designated by the labor and social security department for medical treatment and medicine purchase. The medical expenses incurred will be directly recorded and settled immediately.
(2) Emergency Settlement Procedure Insured persons are hospitalized in non-designated medical institutions in the city or in remote medical institutions due to emergency rescue. The medical expenses incurred shall be paid in advance by the individual or unit. After the emergency rescue is completed, the medical expenses incurred shall be paid based on the hospital emergency medical records and examinations.
, laboratory reports, invoices, and detailed medical fee lists until the medical insurance agency handles the reimbursement procedures in accordance with regulations.
(3) Settlement procedures for relocation of personnel 1. For relocation of relocation staff, the employer shall designate 1-2 designated medical institutions in the place of residence and report them to the medical insurance agency for record.
2. The medical expenses incurred by out-of-town workers who are ill and go to designated medical institutions in their place of residence will be paid in advance by the person or their unit. After the treatment is completed, the unit will pay the insured person's medical certificate and medical record, valid expense receipt, and duplicate
Prescriptions, hospitalization expense lists, etc. must be settled at the social medical insurance agency on the specified date.
(4) Transfer settlement 1. If the insured person is transferred to other medical institutions for diagnosis and treatment due to limited conditions of designated medical institutions or due to specialized diseases, he must fill in the referral approval form.
The treating physician will put forward the reasons for the transfer, the department director will put forward the opinion on the transfer, and the medical institution's medical insurance office will review it, and the director in charge will sign it, and then the patient can be transferred to the municipal medical insurance center for approval.
2. In principle, referrals should be made within the city before outside the city, and within the province before outside the province.
Referrals within the city are stipulated to be conducted between designated medical institutions.
Referrals from outside the city must be made by designated medical institutions above level three in this city.
3. The medical expenses incurred after the insured person is transferred to another hospital shall be paid in advance by the individual or unit in cash. After the medical treatment is completed, the insured person or his agent shall hold the transfer approval form, medical record certificate, prescription and valid documents.
Go to the medical insurance agency to reimburse hospitalization expenses that fall within the scope of payment from the overall fund.