Non-reimbursement scope of rural medical insurance

1, outpatient medical expenses of non-designated hospitals in the region (except outpatient treatment expenses for special diseases), expenses incurred from not seeking medical treatment according to regulations and purchasing medicines by oneself;

2. If there is a third party's responsibility, the medical expenses caused by personal injury shall be borne by the third party responsible according to law, such as traffic accidents;

3. Medical expenses for injuries caused by suicide, self-mutilation, taking poison, taking drugs, fighting and other illegal acts.

The scope of reimbursement for rural cooperative medical care is:

1, outpatient medical expenses of non-designated hospitals in the region (except outpatient treatment expenses for special diseases), expenses incurred from not seeking medical treatment according to regulations and purchasing medicines by oneself;

2. If there is a third party's responsibility, the medical expenses caused by personal injury shall be borne by the third party responsible according to law, such as traffic accidents;

3. Medical expenses for injuries caused by suicide, self-mutilation, taking poison, taking drugs, fighting and other illegal acts.

Can the money in the medical insurance be taken out?

The money in medical insurance is generally not available.

But in the following three cases, the money in the medical insurance card can be withdrawn and used:

1. The medical insurance card is terminated. If the insured dies, the relatives can go through the surrender formalities with the death certificate;

2. The insured emigrates. Handle the withdrawal formalities with the certificate issued by the public security department;

3. Transfer in different places. After local insurance, the balance of medical insurance account can be transferred to a new account.

Medical insurance refers to social medical insurance. It is a social insurance system that meets the basic medical needs of the state and society according to laws and regulations when workers are sick. The advantage of medical insurance is to enjoy treatment according to uniform standards. The same access conditions, the same fees, the same treatment, there is no difference between high and low. The employee's outpatient expenses can be deducted from his personal account and paid by the employee after deduction. Employees' hospitalization expenses are reimbursed in proportion, usually 86% of the expenses of 1 1,000 yuan, 88% of the expenses of 1 1,000-20,000 yuan and 92% of the expenses of 20,000-40,000 yuan. If employees have not been sick for several years in a row, personal account funds can be accumulated.

Social security card is an electronic information card that medical insurance agencies handle for the insured to seek medical treatment and purchase medicines, and is used to verify identity, record and store personal account funds and usage. With my social security card, the insured can seek medical treatment at any designated medical institution in this city or purchase medicines at designated retail pharmacies. Personal account of medical insurance is a special account established according to the basic medical insurance policy, which is specially used to store the medical insurance premiums paid by the insured and the funds allocated by the employer according to a certain proportion, and record the medical consumption. The funds in the personal account are used to pay for the out-of-pocket part of medical treatment and medicine purchase.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: Article 23 of the Social Insurance Law.

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 24

The state establishes and improves the new rural cooperative medical system.

Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.