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Can I use social security card for medical examination?
Reimbursement scope: 1. Medical insurance card reimbursement is limited to medical expenses above hospitalization caused by diseases and some accidents in designated hospitals.
The reimbursement formula is: (total cost-threshold cost-self-funded cost-cost overrun) x(75+ age x0.2)%. In general, the actual reimbursement rate ranges from 20% to 60%.
Self-funded drugs are not reimbursed, 80% of Class B drugs are reimbursed, bed fees are limited, and some inspection fees and medical treatment fees according to regulations cannot be reimbursed.
2. The reimbursement amount of medical insurance card is 4 times of the average salary of local social workers (1 year cumulative value).
3. The money in the medical insurance card can be used to buy medicines at designated pharmacies and pay for outpatient and emergency expenses, but it does not belong to the category of reimbursement, because the money in the medical insurance card is the money in the medical insurance personal account.
Legal basis: Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers.
Twenty-eighth personal accounts are used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.
Twenty-ninth serious illness hospitalization medical expenses, according to the following methods to pay:
(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.
(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.
(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.
The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.
Thirtieth medical expenses below Qifubiaozhun and above the maximum payment limit shall not be paid by the overall fund.
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