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How to check the scope of medical insurance reimbursement

medical insurance inquiry method:

1. social security center inquiry

if you are not clear about your social security account number, you can bring your ID card to the business hall of social insurance agencies in various districts to inquire;

2. Inquire online

Log in to the labor security network or social insurance business website of the city where you live, click the "Personal Social Security Information Inquiry" window, and enter my ID card and password to inquire about my insurance information;

3. Telephone consultation

Call the labor security comprehensive service number "12333" for policy consultation and information inquiry;

4. Touch-screen inquiry

If there is a touch-screen inquiry system for social insurance in the business hall of social insurance agencies in each district, swipe your card or enter the card number or ID number according to the on-screen prompts for inquiry.

scope of reimbursement for medical insurance

1. outpatient and emergency medical expenses: the accumulated medical expenses of employees who meet the scope of basic medical insurance within the year exceed 2, yuan;

2. Settlement ratio: 5% of the part of the dispatched personnel over 2, yuan will be reimbursed during the contract period, and 5% will be paid by the individual; In a year, the maximum amount of accumulated reimbursement for dispatched personnel for outpatient and emergency services is 2, yuan;

3. Insured personnel should properly keep the outpatient medical documents that are treated in designated hospitals as medical expense reimbursement vouchers;

4. Outpatient medical treatment for three kinds of special diseases: When the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person goes to see a doctor will issue a "disease diagnosis certificate", fill in the "Declaration and Approval Form for Special Diseases of Medical Insurance" and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals approved for treatment, and cannot be purchased at designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, and shall be settled with reference to hospitalization;

5. Hospitalization.

Only after paying medical insurance for 2 years can you enjoy medical insurance reimbursement after retirement.

To sum up, with medical insurance, although it can't fully reimburse your illness treatment expenses, it can reimburse a large part, which still plays a significant role for sick people and reduces the financial burden of the family.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations;

article 29

the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.