Employee medical insurance has been paid, why is the balance 0?

The reasons why the balance of medical insurance card is zero are generally:

1. The medical insurance institution has not transferred the account. If the insured person just got the medical insurance card and found that the balance is zero when inquiring, it may be because the medical insurance agency has not officially transferred the money, so just wait patiently;

2. The query method is incorrect. Generally, a social security card contains two accounts, one of which is a bank card account, and the two accounts are not universal. So if you check the balance at ATM, you can only check the balance in the bank card account. If the bank card account has not been used, the balance will naturally be displayed as zero.

3. Flexible employees do not set up medical insurance personal accounts according to the minimum payment, so the balance is zero;

4. There is no personal account for medical insurance for urban and rural residents, so the balance is zero.

Medical insurance reimbursement conditions:

1. In order to obtain medical insurance reimbursement for medical behavior in designated institutions, first of all, the insured person needs to see a doctor or buy medicine in designated medical institutions and pharmacies stipulated by the basic medical insurance in order to obtain reimbursement, otherwise it cannot be reimbursed;

2. If it belongs to the social security catalogue, it is necessary to have medical treatment items or purchased drugs in the social security catalogue to be reimbursed, otherwise it cannot be reimbursed;

3. To reach the deductible standard, medical insurance reimbursement is required. First, the medical expenses incurred by the insured reach the deductible line stipulated by social security, and the part exceeding the deductible line can only be reimbursed within the limit, and the unified proportion is paid by the basic medical pooling fund.

The required materials are as follows:

1, the original valid identity certificate or social security card of the insured;

2, outpatient medical records, inspection, test results report and other original medical information;

3. If it is an agent, you need to provide the original ID card of the agent;

4, the original certificate of disease diagnosis issued by the designated medical institutions;

5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;

6. Original receipt of outpatient charges of medical institutions with unified finance and taxation.

The medical insurance process is:

1. Prepare the ID card of the insured person first;

2. Go to the medical insurance window of the local medical insurance center to apply for the employer's household registration book and related materials, handle the medical insurance according to the staff's tips and procedures, and receive the medical insurance card at the service point within the specified time.

Medical insurance reimbursement process:

1, original ID card or social security card;

2. Original disease diagnosis certificate issued by tertiary or secondary hospitals of designated medical institutions;

3, outpatient medical records, inspection, test results report and other original medical information;

4. Original receipt of outpatient charges of medical institutions with unified finance and taxation;

5. The detailed list of outpatient expenses printed by the hospital or the original payment of prescriptions issued by doctors;

6. Designated pharmacies: unified original invoices and printed lists of tax commodity sales;

7. If acting as an agent, provide the original ID card of the agent.

To sum up, the materials needed for medical insurance reimbursement include hospital medical records, which need doctors to fill in and issue discharge certificates; You also need a general ledger of medical expenses, including medical expenses, hospitalization expenses, operation expenses, nutrition expenses, visits and other expenses that can be reimbursed by medical insurance regulations. In addition, it also includes the original and copy of the party's ID card.

Legal basis:

Article 10 of People's Republic of China (PRC) Social Insurance Law

An insurance contract is an agreement between the applicant and the insurer on the relationship between insurance rights and obligations. The applicant refers to the person who has entered into an insurance contract with the insurer and has the obligation to pay the insurance premium according to the contract.

An insurer refers to an insurance company that has entered into an insurance contract with the applicant and is liable for compensation or payment of insurance benefits according to the contract.

Article 28

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.