Urban insured persons should take the initiative to show the "Medical Insurance Calendar" and use the medical insurance card to settle accounts when they are treated in outpatient service and hospitalization in designated hospitals in cities and towns or in designated hospitals for special diseases. The medical expenses incurred by the insured for medical treatment are paid by individuals in cash, and the medical insurance fund is paid by the designated hospital according to the regulations and settled with the municipal medical insurance center.
Medical insurance card is a functional card with a chip, which is used for identity confirmation and personal account payment of medical insurance when visiting a doctor or a pharmacy. Medical record is a kind of medical record, which can be used in all designated hospitals in the same city to record medical treatment. The medical expenses for hospitalization in the medical insurance hospital of the insured place shall be paid by the individual and settled with the hospital. The part that should be borne by the medical insurance fund, individuals do not need to take money, and the agency will settle with the hospital. The medical insurance card deduction of hospitalization expenses is a one-time deduction, that is to say, the money spent during hospitalization is deducted by the medical insurance card reimbursed by the individual at his own expense when he leaves the hospital.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.