How is the medical insurance fee deducted?

The deduction method of medical insurance is as follows:

1, the main purpose of medical insurance is to pay for outpatient treatment. When going to a designated hospital for medical treatment, present a medical insurance card to prove the identity and registration of the insured. Individuals can directly settle the part of medical insurance reimbursement by medical insurance and hospitals, without paying fees first and then reimbursing. Only at the time of checkout, the self-funded part will be paid by the balance of the medical insurance card or cash;

2. There is a deductible for hospitalization reimbursement (the deductible standard is generally 10% of the average annual salary of employees in the city last year), which means that the money outside the deductible needs to be paid by itself, and the reimbursement ratio varies from place to place, and different hospitals and different projects are different, about 80%. You can go to the local labor and social security online for details.

3. The money in the medical insurance card account can't be used for shopping and cashing, but the following expenses can be paid: drug purchase expenses in designated retail pharmacies, emergency medical expenses, personal purchase of commercial insurance and accidental injury insurance;

4. Precautions: When the number of medical insurance card transactions reaches 60 times, the insured employees must go to China Bank Savings Office to print the transaction records, otherwise they will stop using the card. After the transaction record is printed, the card can continue to be used.

Social security card to the hospital reimbursement process;

1, the holder of the medical insurance card shows the medical insurance card to the designated hospital to prove the insured identity;

2. At the end of the patient's discharge or diagnosis and treatment, the part paid by the individual shall be paid by himself with a medical insurance card or cash;

3. In addition, the part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay first and then reimburse.

To sum up, the reimbursement under the overall planning situation means that after the overall planning account is reimbursed according to the corresponding proportion, the remaining medical expenses after deducting the medical insurance reimbursement part can be deducted from the personal account balance.

Legal basis:

Article 28 of the Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.