Hangzhou medical insurance mutual aid account

First, the establishment of family mutual health account documents:

(1) Zhejiang People's Social Development [2016] No.62, Notice of Zhejiang Provincial People's Social Welfare Department and other four departments on Further Adjusting and Perfecting the Relevant Policies of Personal Accounts for Employees' Medical Insurance.

(II) Notice of Yongren ShefaNo. [20 16] 126 on Adjusting the Use Mode of Balance Funds in Individual Accounts of Basic Medical Insurance over the Years.

Second, how to form a family mutual aid network:

(A) the concept of family support network

In order to improve the efficiency of the use of personal account balance funds of employees' medical insurance over the years, the insured can form themselves and other family members according to the needs of family members, and use the accumulated account funds in family members for the needy members, so as to realize the mutual sharing of account funds over the years and reduce the burden of family medical expenses.

(B) the method of establishing a family support network

1. Ningbo Medical Insurance Pass APP.

2. Self-service terminal processing

3. The window of the agency shall be handled.

Note: There are three ways to handle it, mainly push APP and self-service terminal, and try to weaken the window handling.

(C) the conditions for the formation of a family mutual aid network

1. Organizer: It must be an insured person who has participated in the basic medical insurance for employees in Ningbo and has a balance in each account over the years.

2. Members of Gong Ji. Com: people who participate in the basic medical insurance for employees in Ningbo (including hospitalization insurance) or the basic medical insurance for urban and rural residents (excluding children of government agencies and institutions, retired cadres, second-class and second-class disabled soldiers and other co-ordinators).

3. There are only three relationships between members and promoters: spouse (limited to 1), parents (limited to 2) and children (unlimited);

4. The social security cards of promoters and members must be in a normal state, as long as the account status has not been revoked or revoked and liquidated;

5. Each insured person can only join one family support network.

(D) The formation process of family mutual aid network

1. Ningbo Medical Insurance Pass APP.

The sponsor must register in Ningbo Medical Insurance APP and pass the real-name authentication before he can apply for the establishment of a family support network on the medical insurance APP family support network page, and then select the relationship between family members and the sponsor to add members. After adding, the payment order must be determined, and the payment order of the sponsor is the first by default;

2. Self-service equipment terminal processing

Sponsors can apply to the nearest social security hall and street human social security self-service equipment to form a family mutual aid network with their social security cards or ID cards. After the establishment, add family members, and determine the relationship between the included family members and the sponsors and the payment order. By default, the payment order of the sponsor is the first.

3. The window of the agency shall be handled.

The sponsor must hold the social security card of himself and the family members to be formed, and apply for the establishment of a mutual aid network at the service window of the medical insurance (social security) agency where the sponsor is insured. After the application, the relationship between the included family members and the sponsor and the payment order must be determined, and the payment order of the sponsor is the first by default;

Characteristics of three treatment methods

APP: you need to register and pass the real-name authentication, but it is not limited by time and space, and the operation is simple;

Self-service terminal: you don't need to register, you just need to bring your social security card or ID card. The equipment only recognizes cards but not people. You can go to the nearest institution or the self-service terminal on the street to handle it.

Window processing: you must bring a social security card (you must swipe your card to enter the system to handle this business), and you must go to the agency where the applicant is insured, and you can't do it on your behalf. The agency needs to print the application form and file it.

Three, the transfer of funds in the health mutual account

(A) the concept of mutual aid in health accounts

After the establishment of the family mutual-aid network, each insured person who is included in the family mutual-aid network can transfer all or part of the funds from his account over the years to his own mutual-aid health account as needed, and the funds in the mutual-aid account will still be transferred to himself, and the funds transferred to the mutual-aid account can also apply for re-transfer to the account over the years.

Note: On the premise of the original current year's account and the previous year's account of employees' basic medical insurance, each network member will set up a new family mutual network health account.

(2) Transfer funds from the Masonic Health Account.

1. Transfer immediately.

Conditions: the account status of the insured must be normal when operating, and the insurance coverage must be the insured of the basic medical insurance for employees in this city. You can apply to transfer part or all of your account funds over the years to your mutual aid account through Ningbo Medical Insurance APP, human social security self-service terminal and handling window, and vice versa.

2. The preset funds in the Masonic Health Account are transferred.

Insured persons who are covered by the basic medical insurance for employees in this city and have joined the family mutual aid network can preset an amount through the Ningbo Medical Insurance APP, the human social security self-service terminal and the window of the handling institution (as long as the account status has not been revoked or revoked during the preset operation), and transfer once a year after the preset operation is completed (scheduled for June 1).

There are two situations when the system is pulled out:

(1) When the system withdraws money, the balance of the account over the years is less than the preset amount;

(2) The account status is abnormal and the system will not write it out.

explain

(1) Every member who passes the APP must register in the Ningbo Medical Insurance APP and pass the real-name authentication. After establishing a mutual aid network, sponsors can add or delete members and change the payment order, but they have no right to transfer funds in members' accounts.

(2) Through the handling window: I must use my social security card to handle the fund transfer of my account and mutual aid account over the years at the handling window of my insured place, and agency is not supported. The promoters also have no right to transfer funds in members' accounts.

Fourth, medical settlement of health mutual aid account

When the insured person goes to the hospital for medical treatment (including going abroad for medical treatment and living in different places for medical treatment or sporadic reimbursement), the funds in the health mutual aid account can be used by himself and network members according to regulations. Each member first uses the funds from his personal account over the years, and then uses the funds from his mutual health account. When he doesn't have the funds in the mutual aid network account or his personal account is insufficient over the years, he can use the funds in the mutual aid health accounts of other members in the network according to the set payment order. Only one health mutual account fund can be used for one settlement.

Note: All usage rules of the Masonic Health Account are the same as in previous years (including usage rules of self-expense, conceit and commitment). , and the user account status is abnormal and cannot be used by members).

For example, the initiator of a family support network is A, and there are members B and C in the network. For example, a calendar year account funds 1000 yuan, Gong Ji calendar year account funds 1000 yuan, Gong Ji calendar year account funds 1000 yuan, c no account funds, b cumulative medical expenses1000 yuan.

Verb (abbreviation of verb) Change, cancellation and cancellation of family mutual aid network

(1) Sponsor

After the promoters establish the mutual aid network, they can add or delete the members of the mutual aid network at any time, or change the payment order of the mutual aid accounts of the members in the network, or cancel the established mutual aid network. After the cancellation of the mutual aid network, it is deemed that the mutual aid network is dissolved, and other members in the network are deemed to have withdrawn from the mutual aid network.

(2) Members in the network

Other network members only have the right to opt out of the mutual assistance network.

Refund and change of medical expenses in the account of intransitive verbs.

If the insured person has used the Masonic health account when seeking medical treatment, the medical expenses will be refunded or changed. The general principle is to return it in the original way of use. However, if the former members of the Masonic Network have withdrawn from the Masonic Network at the time of refund, this part of the funds will be returned to the insured's account in the previous calendar year, but will not be returned in real time. The system will return to a virtual freemasonry account at the time of refund, then synchronize every night and return to the calendar year account the next day.

For example, network member A used the funds of mutual aid account of network member B when seeking medical treatment. Later, A made a refund in the hospital for some reason, and member B withdrew from the mutual aid network during the refund, so the system temporarily retained the funds of B's original mutual aid account after the refund, and will return to the previous account the next day.

Seven, mutual account liquidation:

(a) the insured person needs to liquidate his personal account due to death, transfer and other reasons.

Over the years, the balance of funds originally allocated from the account was transferred to the Gong Ji account. Com still belongs to the insured, that is, when the personal account is liquidated, the balance of the insured's account over the years will be added with the balance of the Gong Ji account, and then the interest will be calculated, and then the payment and transfer will be made according to the law of account funds over the years.

(2) year-end unified calculation of mutual aid accounts.

First, transfer the funds in the mutual aid account back to the balance over the years, then calculate the interest, and the calculated interest amount will be added to the balance of the insured account over the years.

Eight, family mutual help network business query:

1. Personal account inquiry: add a special button on the right.

2. Personal account inquiry-personal account fund inquiry: add a mutual account list.

3. Personal account inquiry-cost: use of Canadian aid account.

4. There are also several batch queries: public network construction query, public network information change query and public network account change query.

The above information is for reference only, please refer to the local policy 12333 for details.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.