How to query the balance of medical insurance reimbursement amount

The query method of medical insurance reimbursement amount is as follows:

1, local query. Insured persons can directly bring their identity documents and resident medical insurance cards to the service hall of the local social security bureau to print the payment list, and can inquire about relevant information in detail;

2. Telephone inquiry: directly call the Social Security Bureau at telephone number 12333 for inquiry;

3. Inquire online, find the website of the local social security bureau online, and enter personal information such as personal social security card account number to find your latest account information.

The calculation method of medical insurance reimbursement ratio is as follows:

1. The reimbursement rate within the scope of the medical insurance policy is equal to the medical insurance reimbursement expenses divided by the reportable expenses. When the reportable expenses are fixed, if the reimbursement ratio is high, the value of the medical insurance reimbursement expenses needs to be large, and the medical insurance reimbursement expenses are equal to the reportable expenses-part of the policy payment-deductible line multiplied by the overall fund payment ratio. It can be seen that the medical insurance department can increase the reimbursement expenses of medical insurance by reducing part of the policy self-payment, lowering the deductible line and increasing the proportion of overall fund payment, so as to increase the proportion of reimbursement within the medical insurance policy;

2. The actual reimbursement ratio is equal to the medical insurance reimbursement expenses divided by the reportable expenses plus the unreported expenses. When the value of unreported expenses is small, the larger value of medical insurance reimbursement expenses can increase the actual reimbursement ratio. However, if the value of non-reportable expenses accounts for a large part, even if the medical insurance pooling fund pays 100% of reportable expenses, the actual reimbursement ratio is very low. For example, in this case, 1 1323.02 yuan accounts for a large proportion of unreported expenses. Even if medical insurance reimbursement expenses = reportable expenses =7755.2 1, the actual reimbursement ratio is only 40.65%.

To sum up, the remaining amount of personal medical insurance reimbursement can be found through the service hall of the local social security bureau, telephone or online inquiry.

Legal basis:

Measures for the administration of individual rights and interests records of social insurance

essay

Social insurance agencies are responsible for the management of social insurance personal rights and interests records and provide services related to social insurance personal rights and interests records.

The comprehensive information management institution of human resources and social security (hereinafter referred to as the information institution) provides technical support and security services for the personal rights and interests record of social insurance.

The administrative department of human resources and social security shall supervise the management of individual rights and interests records of social insurance.