What is a medical insurance suspension?

The termination of medical insurance means that medical insurance is not in the state of payment, that is, it is terminated. Simply put, the unit did not pay medical insurance, and the individual did not pay flexible employment social security. However, after entering the new unit, the new unit will continue to pay social security by increasing social security personnel, and then inquire about the medical insurance payment information, which is not a suspension of medical insurance.

Generally speaking, when employees leave their jobs, the original unit will stop the insurance by reducing the number of employees. Inquiring about medical insurance payment information at this time means that medical insurance is suspended. However, after entering the new unit, the new unit will continue to pay social security for employees, and then inquire about the payment information of medical insurance. This is not a suspension of medical insurance, but a normal state of participation.

It should be noted that the medical insurance is broken 1 month, and it will not be reimbursed from the second month. But you can use the personal account balance in the social security card. You can go to the outpatient or emergency department of a designated hospital and buy medical insurance drugs in a medical insurance pharmacy.

Of course, if the medical insurance is cut off, as long as the arrears are paid within 3 months after the medical insurance is cut off, the medical insurance benefits will be enjoyed from the date of normal payment. If the medical insurance has been cut off for more than 3 months, after the arrears are paid off, there will be a waiting period of 180 days to enjoy the medical insurance benefits, that is, from the date of normal payment, 180 days later to enjoy the medical insurance benefits.

First, the coverage of medical insurance.

Broadly speaking, simply speaking, the scope of medical insurance mainly refers to the people covered by medical insurance and the degree of medical security enjoyed by this group. For example, China's basic medical insurance system for urban workers stipulates that "all employers in cities and towns, including enterprises (state-owned enterprises, collective enterprises, foreign-invested enterprises and private enterprises), organs, institutions, social organizations, private non-enterprise units and their employees, must participate in the basic medical insurance". The American medical insurance system for the elderly provides medical insurance for the elderly over 65 years old and those who receive social welfare benefits due to disability and chronic nephritis. The old-age medical insurance law promulgated according to 1965. For another example, social medical insurance in France pays special attention to the protection of some special diseases. For some patients who need long-term treatment and have high costs, such as tuberculosis, leprosy, tumor, diabetes, etc., except for the examination fee and the service fee of private sanatorium, the rest expenses are reimbursed at 100%.

In a narrow sense, the scope of medical insurance coverage is usually defined by the scope of medical insurance liability and the exclusion of medical insurance liability. For example, in Germany's social medical insurance, the medical services covered include outpatient treatment, dental treatment (including maxillofacial plastic surgery and provision of dentures), provision of drugs, bandages and auxiliary treatment, family medical care and housework help, hospitalization, artificial replacement materials, psychological and functional rehabilitation and work ability rehabilitation. For another example, Singapore's dual health insurance plan stipulates that the total compensation for medical expenses received by patients from the plan should not exceed S $70,000; According to the health savings plan, the daily hospitalization fee for health savings is S $300, and the doctor's rounds fee is S $50. If there is an overrun, the patient should be paid in cash.

Legal basis:

Article 23 of the Social Insurance Law of People's Republic of China (PRC), employees shall participate in the basic medical insurance for employees, and the employer and employees shall jointly pay the basic medical insurance premium according to the provisions of the state. 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.