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How to handle the medical insurance for a one-year-old child?
1. Apply for social security card

According to the policy arrangement, the relevant departments will issue an application form to every school-age baby through grassroots organizations such as neighborhood committees. After the new parents fill it out, they can bring the household registration book, the ID card of the agent (that is, the new father or mother) and the card handling fee of 25 yuan to the social security center.

Different from the adult social security card, the baby social security card does not need to take photos by itself, and the process should be more convenient. 2. Apply for medical insurance benefits

The above application is only a card, but the content of the social security card (that is, medical insurance benefits) needs to be handled separately. Of course, some neighborhood committees may be able to do it together.

At this point, the new parents should bring the original four kinds of certificates and their copies to the corresponding neighborhood staff, namely:

A. Baby's birth certificate and its copy

B a copy of the first page of the baby's household registration book and a copy of the baby's own household registration book (generally on the household registration book)

C. One page of the parents' household registration book and its copy

D. ID card and photocopy of the agent (new father or new mother).

According to the policy, new parents need to pay the insurance premium in 60 yuan before March 20th every year, and the specific time and method of payment will be notified separately. 3. Specific standards for children's medical insurance

According to the regulations, the term of children's medical insurance is 65438+ 10/0 to 65438+February 3 1 every year. It does not include critical illness insurance, but covers outpatient and emergency expenses and hospitalization expenses. The specific criteria are as follows.

Outpatient and emergency: the personal burden of the first-class hospital (that is, community hospital) is 40%.

Second-and third-class hospitals are 50% conceited.

Hospitalization: 50% within the medical insurance standard

4. Similarities and differences with children's hospitalization fund

So, what are the similarities and differences between this new type of children's medical insurance and the same 60 yuan/year children's hospitalization fund? Can I enjoy both?

In fact, the children's hospitalization fund is organized by the Shanghai Red Cross Society, mainly for hospitalization and critical illness insurance, excluding outpatient and emergency services. Therefore, it is complementary to children's medical insurance and can be enjoyed at the same time.

In terms of the specific term, the children's hospitalization fund does not take a natural year as the term, but runs from September of that year 1 to August of the following year1,which is also different from children's medical insurance.

The reimbursement standards for the "hospitalization" part that the two can guarantee are also different. Children's medical insurance can be reimbursed 50% as long as it is within the scope of medical insurance, and children's hospitalization fund has a minimum payment standard (50 yuan, a first-class hospital, 100 yuan, 300 yuan, a third-class hospital), that is, 50% can be reimbursed above this standard. At the same time, there is a cumulative maximum payment of 654.38+10,000 yuan per person per academic year. 5. You can't enjoy labor insurance with your family at the same time.

After handling the children's medical insurance, the original family members in the unit can't enjoy labor insurance at the same time. As for the specific provisions of the latter, see New Dad Diary 8 for details. For example:

Too much talk is not as clear as examples.

/kloc-0-year-old baby Weiwei paid the medical insurance participation fee in 60 yuan at the beginning of the year and the children's hospitalization fund fee in 60 yuan in August. 65438+ 10 went to the hospital and spent 1 10,000, divided into three specific projects.

1 000 yuan for outpatient and emergency services, of which 900 yuan is reimbursed by medical insurance, and 50% is reimbursed by medical insurance, that is, 450 yuan.

Hospitalization of 4000 yuan (secondary hospital) is within the scope of medical insurance. Children's medical insurance will be reimbursed 50%, that is, 2,000 yuan, the remaining 2,000 yuan will be deducted from the deductible line 100 yuan, and the remaining 50% will be reimbursed by children's hospitalization fund, that is, 1950 yuan.

The serious illness of 5,000 yuan is within the scope of medical insurance, and 50% of it is reimbursed by the children's hospitalization fund, which is 2,500 yuan.

So he can reimburse 450+3950+2500=6900 yuan.

Note: The above words are for personal understanding and reference only. If you have any questions about the interpretation of the policy, please consult the social security hotline 962222, the medical insurance hotline 962 18 and the labor security hotline 12333.