How to query your own medical insurance information for urban and rural residents? The implementation of the basic medical insurance for urban residents has accelerated China's socialist modernization and laid the foundation for the final realization of the integration of urban and rural areas with basic medical insurance. How to query your own medical insurance information for urban and rural residents?

How to query your own medical insurance information for urban and rural residents 1 1, social security official website query:

Users can log in to the social insurance public service platform of the insured place, click Individual User Login, and after logging in, they can find "Information Query"-"Personal Medical Insurance Query" on the page to query the individual payment information of basic medical insurance for urban and rural residents.

2, mobile APP query:

In some areas, there will be special government apps. Take Fuzhou as an example, the insured can download a Fujian Tax Pass APP. After opening, you can see the query of urban and rural medical insurance payment records on this page. After input, you can correctly input the ID number, initials and time interval of the insured, and click Query to find the relevant payment information.

3. WeChat query:

Generally, each region has its own official account of "xx Tuhao" WeChat. You can enter the residents' medical insurance directly in the background, and then the local urban and rural residents' medical insurance information will come out. Including the query of urban and rural residents' medical insurance, click the link provided above to enter the entrance of medical insurance payment query, and then enter the correct information according to the page prompts to query.

4, to the medical card issuing bank query:

At present, people's work is very tense. No one wants to go to the service hall of the Social Security Bureau in person. Sometimes the line is busy and some problems can't be explained clearly on the phone. Therefore, more people prefer the way of online personal inquiry of urban residents' medical insurance.

Generally, the websites that provide medical insurance card balance inquiry are local social labor and social security websites, that is, official website of Social Security Bureau. Enter the personal inquiry system of medical insurance for urban residents, enter the personal ID number, and inquire about the payment and balance of social insurance.

The above is the introduction of how to query the medical insurance payment records of urban and rural residents. It should be noted that the query system in different regions may be different. I suggest you consult the local authorities first. If you don't want to check online, you can also go to the local medical insurance department or tax department to check.

Medical insurance for urban and rural residents is paid once a year, and the centralized payment time is from September to 65438+February every year. The payment amount is generally uniform nationwide, but there are differences in some provinces and cities. If there is demand in this respect, it is recommended to pay close attention to the relevant information of the location.

How to query your own medical insurance information for urban and rural residents? 2. In 2022, the basic medical insurance for urban and rural residents has begun to pay, and the payment standard is 320 yuan per person. Residents who were insured before 20021and 65438+February 3 1 can enjoy the basic medical insurance and serious illness insurance for urban and rural residents from 65438+2022 10 to 65438+February 2022.

First, the basic medical insurance benefits for urban and rural residents include general outpatient medical care, chronic disease outpatient medical care, serious and serious disease medical care and hospitalization medical care.

1, general outpatient service. In 2022, there will be no deductible for general outpatient medical expenses incurred by insured residents in designated medical institutions, and the reimbursement ratio will be 60%. The cumulative maximum payment limit for a treatment period is 360 yuan per person; Insured residents who are included in the coverage of "two diseases" have no deductible for outpatient medication of "two diseases", and the reimbursement ratio is 60% within the policy scope of township medical institutions (community health service centers) and village medical institutions, and the cumulative maximum payment limit during the period of enjoying a treatment is 200 yuan per person.

2. Outpatient chronic diseases. At present, there are 27 kinds of chronic diseases in outpatient clinics in our city. After the insured residents have passed the identification of chronic diseases, there is no deductible for the medical expenses of outpatient chronic diseases that meet the requirements, and the basic medical insurance fund pays 70%.

3. Serious and serious diseases. There is no Qifubiaozhun for medical expenses incurred by insured residents who meet the standards of serious diseases in our province and city. There are 33 kinds of inpatients with serious diseases, and the medical expenses within the price limit standard are paid by the basic medical insurance fund in proportion, with 80% of county-level medical institutions, 70% of municipal medical institutions and 65% of provincial medical institutions; There are 7 kinds of serious outpatient diseases and 93 kinds of specific outpatient drugs. The outpatient medical expenses that meet the requirements within the quota standard are included in the payment scope of the basic medical insurance fund, and the payment ratio is 80%.

4. Hospitalization. Qifubiaozhun for township hospitals (community medical institutions) 150 yuan, with reimbursement rate of 90%; The qifubiaozhun for hospitals at and below the county level (including the second level) is 400 yuan, with 63% for 400- 1500 yuan and 83% for 1500 yuan and above; Qifubiaozhun 500 yuan, the city's hospitals below the second level (including the second level), the reimbursement rate of 500-3000 yuan is 55%, and the reimbursement rate of more than 3000 yuan is 75%; The qifubiaozhun of tertiary hospitals in the city is 1200 yuan, and the reimbursement rate of 1200-4000 yuan is 53%, and the reimbursement rate of more than 4000 yuan is 72%. Qifubiaozhun for provincial hospitals below Grade II (including Grade II) is 600 yuan, with 53% for reimbursement of 600-4,000 yuan and 72% for reimbursement of more than 4,000 yuan; The deductible line of provincial tertiary hospitals and hospitals outside the province is 2000 yuan, the reimbursement rate of 2000-7000 yuan is 50%, and the reimbursement rate of more than 7000 yuan is 68%. Maximum payment limit: the annual maximum payment limit of the basic medical insurance pooling fund is 6.5438+0.5 million yuan.

2. Critical illness insurance: Medical expenses incurred by insured residents in an insurance year (including outpatient medical expenses for chronic diseases and special diseases, outpatient specific drugs, etc.) will be reimbursed by the basic medical insurance, and the part of medical expenses borne by individuals that exceeds RMB1.1million within the policy scope will be reimbursed by the critical illness insurance fund according to the following ratio:/kloc. The part of more than 654.38+ 10,000 yuan shall be reimbursed at 70%. Maximum payment limit The maximum payment limit for major illness insurance in that year is 400,000 yuan.

How to inquire about your own medical insurance information for urban and rural residents 3 scope of medical insurance reimbursement

The basic medical insurance fund covers the hospitalization expenses and outpatient medical expenses of patients with chronic diseases. The payment scope of the overall fund shall comply with the relevant provisions of the national, provincial and municipal basic medical insurance drug list, diagnosis and treatment items and service facilities list, payment standards and social insurance laws and regulations.

The following medical expenses are not included in the scope of payment of the overall fund:

(1) Except for instant settlement on the online settlement platform, there is no original bill for medical expenses in different places;

(2) Outpatient expenses incurred in violation of regulations during hospitalization;

(3) Medical expenses incurred by non-designated medical institutions;

(four) other circumstances stipulated by the state and the province.

Medical insurance reimbursement conditions

1. Employees newly insured and re-insured after interruption of payment 1 year or more, who have participated in the basic medical insurance according to law and paid for 6 consecutive months (excluding the overdue period), shall enjoy the basic medical insurance benefits according to regulations;

2 continuous payment of less than 6 months, do not enjoy the basic medical insurance benefits;

3. If the payment is interrupted for less than one year, you will enjoy the treatment according to the regulations after re-insurance payment;

4 interrupt payment personnel do not enjoy the basic medical insurance benefits during the interruption of payment.

Proportion of medical insurance reimbursement

First, the proportion of hospitalization reimbursement

1. First-class hospital, the part above Qifubiaozhun is up to 90% of the maximum payment limit;

2. Secondary hospitals pay 85% of the minimum deductible line 1 10,000 yuan (inclusive) and 90% of the maximum payment limit 1 10,000 yuan;

3. 80% of the minimum deductible of tertiary hospitals is above 5,000 yuan (inclusive), 85% of the minimum deductible of 5,000 yuan to 10000 yuan (inclusive), and 90% of the maximum deductible of 10000 yuan.

4. Retirees will increase by 5% on the basis of the above payment ratio.

Second, hospitalization reimbursement deductible line

1. Level I Hospital 200 yuan;

2.500 yuan, a secondary hospital;

3.800 yuan, a tertiary hospital;

4. For patients with malignant tumor, medical expenses incurred by radiotherapy and chemotherapy for many times in a medical year are deductible only once.

Third, the proportion of outpatient reimbursement for chronic diseases.

Outpatient chronic diseases are divided into Class A chronic diseases and Class B chronic diseases.

1. Outpatient medical expenses that meet the requirements of patients with chronic diseases of Class A shall be paid by the overall fund at 85%. The cost of outpatient hemodialysis, peritoneal dialysis and cyclosporine A after organ transplantation in patients with chronic renal failure (renal failure stage) increased by 10 percentage point.

2. Qifubiaozhun for Class B chronic diseases: 300 yuan. The outpatient medical expenses paid by patients with chronic diseases of Class B who meet the deductible standard above 80% shall not exceed the maximum payment limit of chronic diseases within one medical year (or validity period).

3. The insured can identify two chronic diseases of Class B at the same time, and manage them according to the first identified double diseases, and calculate the deductible for each disease separately. The identification and management of chronic diseases and the maximum payment limit shall be adjusted by the human resources and social security department according to the overall fund income and expenditure. The standards, rules and procedures for the identification of chronic diseases shall be formulated separately by the municipal administrative department of human resources and social security.

Fourth, the maximum amount of medical insurance reimbursement

In a medical year, the hospitalization medical expenses and chronic disease outpatient medical expenses paid by the overall fund cannot exceed the maximum payment limit. The maximum payment limit of the overall fund is 250,000 yuan. The municipal administrative department of human resources and social security shall timely adjust the Qifubiaozhun and the maximum payment limit of the overall fund according to the wage level of employees and the income and expenditure of the overall fund.