Medical insurance payment is to use the money in the overall account to pay the relevant medical expenses of the insured. The medical insurance fund consists of overall funds and individual accounts. The overall fund is mainly used to pay medical expenses such as hospitalization expenses of chronic outpatients, outpatient specific items and fixed Medicaid within the basic medical scope, above the Qifubiaozhun of the overall fund and below the maximum payment limit. Personal accounts are mainly used to pay the general outpatient expenses that meet the basic medical insurance, the drug purchase expenses of designated retail pharmacies, and the expenses borne by individuals in the specific items of chronic diseases for employees' hospitalization and outpatient service. Personal account payment is to use the money in personal account to pay the related medical expenses of the insured.

Medical insurance is divided into two accounts,

1. The money reflected in the personal account and medical insurance card can be used to buy medicines at designated pharmacies, pay outpatient expenses and pay the part paid by individuals in hospitalization expenses;

2. The overall account is managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement are paid by the overall account.

When seeking medical treatment, show the medical insurance card to the designated hospital to prove the identity and registration of the insured.

The part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay in advance before reimbursement. At the time of checkout, the part paid by the individual is paid by the balance of the medical insurance card and cash.

There is a deductible for hospitalization reimbursement (the deductible standard is generally 65438+ 00% of the average annual salary of employees in the city last year).

In other words, you need to pay the deductible, and the part that exceeds the deductible can be reimbursed according to the local medical insurance regulations. The proportion of reimbursement varies from place to place, and different projects in different hospitals are also different. You can go to the local labor and social security online for details.

The newly insured business card printing takes two months to get the card. Are you dealing with medical insurance for urban workers, residents or flexible employees? The proportion and time of different types of enjoyment are different. Take the medical insurance for flexible employees, you must pay the normal fee for half a year to enjoy hospitalization. No matter what kind of medical insurance, you need to go to a designated hospital for medical treatment or hospitalization-a designated medical insurance hospital (or live in Baoding). Such hospitals use a unified medical insurance system to swipe their cards.

legal ground

People's Republic of China (PRC) social insurance law

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.