Medical insurance for migrant workers (also known as cooperative medical care and labor medical care), you can swipe your card to see common diseases in the bound social health center, and you can't swipe your card if some expenses are not covered by social security, so you have to pay for it yourself.
Hospitalization insurance, you can also swipe your card at the bound social health center to see the clinic. The use method is the same as above. Migrant workers' medical insurance or hospitalization insurance, social security cards do not deduct outpatient credit cards (no personal accounts), and use outpatient pooling funds.
Comprehensive medical insurance is a common outpatient disease, that is, swipe your card and use the money in your own account (comprehensive medical insurance has a personal account). If the money in the personal account of medical insurance runs out, you can only pay for it yourself. Unless the clinic is seriously ill, you can use social security to keep accounts and pay less or no money yourself. There are rules for these serious illnesses. At present, Shenzhen stipulates that 17 kinds of serious illness clinics can be seen by social security, and they must be seen in social security designated hospitals. So it is better to get sick less, and good health is the greatest wealth.
The number of serious outpatient diseases has increased to seventeen.
The newly issued "Measures for the Administration of Serious Diseases in Outpatients of Shenzhen Social Medical Insurance" has increased the types of serious diseases in outpatients from 3 to 2 *** 17.
The first category includes: hypertension (stage II and III), coronary heart disease, chronic cardiac insufficiency, liver cirrhosis (decompensated stage), chronic viral hepatitis (types B and C, active stage), moderate or above chronic obstructive pulmonary disease, rheumatoid arthritis, systemic lupus erythematosus, diabetes, thalassemia or marine anemia, aplastic anemia, hemophilia and Parkinson's disease.
The second category includes: outpatient dialysis for chronic renal insufficiency (uremia), organ transplantation (anti-rejection therapy), outpatient chemotherapy, radiotherapy and radionuclide therapy for malignant tumors.
The relevant provisions of the first category of outpatient serious illness apply to the insured of comprehensive medical insurance; The second category applies to comprehensive medical insurance, hospitalization medical insurance and migrant workers' medical insurance.
Besides hospitalization. Social security can be used for hospitalization. There are some differences in the reimbursement rates of several medical insurances, but the differences are not great. For hospitalization, part of the money is not spent on your personal account. As long as the hospitalization deductible is above and the maximum payment limit of the overall fund is below, the basic medical insurance serious illness overall fund will pay in full. The hospital keeps accounts first, and then the hospital settles accounts with the social security bureau.
Frequently asked questions of netizens:
1. Are all medical expenses deducted from the social security card?
Excuse me, is the cost of seeing a doctor deducted from the social security card, or is it partly deducted from the social security card and partly paid in cash?
A: If it is a deep household, the outpatient fee can be deducted from the social security card, but some drugs cannot be deducted from the social security and must be paid in cash;
Not a magic fox, but if the company buys you comprehensive medical care or something. Medical expenses can be deducted from the social security card.
If it is not a deep account, and the company only bought hospitalization insurance. Of course you can't use it when you see the clinic. You can only use it when you are in hospital.
2. If it is a temporary population, what about hospitalization insurance? Buy a comprehensive one, okay? Good for the company or good for the individual?
Answer: comprehensive, good for individuals, but expensive. The state has no mandatory requirement for this, so most companies are reluctant to provide this.
Even for deep households, if the drugs involved in outpatient or hospitalization are non-social security drugs, they should pay for them themselves. Want to know the detailed differences between several kinds of medical insurance, please see what medical insurance is more cost-effective in Shenzhen?
My father will come from the mainland. Can my father use my husband's medical insurance card when he is hospitalized? Has anyone tried it?
This is against the rules.
Netizen's reply is for reference only: outpatient service should be ok, even in Peking University Hospital. There is no money on my LG card. Tell the doctor that you can use my social security card to open my name. My mother-in-law also pulled out her teeth with my card. For doctors, as long as they can collect money, they don't care how you pay. But you've never been in hospital. You can ask the doctor who treated your father.
4. Will I deduct the money from my social security card when I use social security to see a doctor?
Answer: It depends on what kind of medical insurance you have. You can also use outpatient credit card for hospitalization insurance, but instead of deducting money from social security card, you can use outpatient co-ordination fund. If you can't get the fund, you must use cash.
If it is comprehensive medical insurance, there is a medical personal account in the social security card. If you use social security to see a doctor, you will deduct the money in the social security card, that is, the money in the medical personal account.
All of the above are for general outpatient service. If you are hospitalized, you won't deduct the money from the social security card. As long as the hospitalization deductible is above the maximum payment limit of the overall fund, the basic medical insurance serious illness overall fund will pay in full.
5. How to check the details of medical expenses?
Answer: Those who participate in comprehensive medical insurance can check the balance of medical insurance online. One of the results of personal social security inquiry is the balance of medical insurance. I can't find the details of medical expenses online. You can check the details of medical insurance expenses in the Social Security Bureau window.
Shenzhen social security inquiry
6. How to use the personal medical insurance card? Can the whole family use it now?
Answer: If the accumulated amount of personal account reaches 1 month, it is the average monthly salary of employees in the previous year (currently 3,233 yuan), and the excess is used to pay the outpatient medical expenses of all family members. The plan has been reported to the Shenzhen Municipal Government and is expected to be promulgated and implemented in the near future. All family members include parents, spouses, children, etc. And regardless of whether the family members are registered in Shenzhen or not, whether they have participated in medical insurance.
Since last year (2008), Shenzhen has taken the lead in implementing the "family account" model of medical insurance in which one person participates in the insurance and the whole family benefits. The Measures of Shenzhen Municipality on Social Medical Insurance, which was implemented on March 1 2008, stipulates that if the accumulated amount of individual accounts reaches the average monthly salary of employees in the previous year, the excess can be used to pay for health check-ups, vaccination fees and the fees already paid.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.