Individual contributions for medical insurance can be paid monthly or monthly, and the omission in January will affect the use of medical insurance.

Payment time of medical insurance:

1. Payment is required every year. The payment period is from November 1st to December 1th every year;

2. After the insured pays the full amount, they will enjoy medical insurance benefits according to the regulations from January 1st to December 31st of the following year.

medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks.

the medical insurance fund is established through the payment of employers and individuals, and the insured will be given certain economic compensation by the medical insurance institution after the medical expenses are incurred.

reimbursement conditions

according to article 28 of the social insurance law, medical expenses that meet the standards of the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

according to the basic requirements for the payment of basic medical insurance benefits in China, the insured must generally meet the following conditions when he goes to the medical insurance institution to reimburse the medical expenses incurred by his own medical treatment:

(1) The insured must go to the designated medical institution of basic medical insurance to seek medical treatment and purchase medicines, or purchase medicines from the designated retail pharmacies determined by the social insurance institution with medical prescriptions issued by doctors in designated hospitals.

(2) The medical expenses incurred by the insured in the process of seeing a doctor must conform to the scope and payment standards of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, before they can be paid by the basic medical insurance fund according to regulations.

(3) among the medical expenses that the insured meets the payment scope of the basic medical insurance, the part above the threshold of the social medical pooling fund and below the maximum payment limit shall be paid by the social medical pooling fund in a unified proportion.

reimbursement ratio

1. outpatient and emergency medical expenses: the medical expenses that meet the scope of basic medical insurance for employees in the year (from January 1 to December 31) have accumulated more than 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 (including receipts and prescriptions below a large amount) 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 the designated hospitals approved for treatment, and cannot be purchased at designated retail pharmacies. If the medical expenses incurred meet the prescribed scope of outpatient special diseases, they 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.

the reimbursement rate of medical insurance varies from place to place. please refer to the local policy for details.