Job Recruitment Website - Social security inquiry - I paid medical insurance, but the balance was 0.
I paid medical insurance, but the balance was 0.
1. In the process of paying social security, company personnel may only pay endowment insurance and forget to pay medical insurance; 2. Urban residents' medical insurance is paid once a year, and there is no accumulated payment period, so there is no personal account balance; 3. Pay medical insurance as a flexible employee, and the payment amount is low, and no personal account is established, resulting in no balance in the account; 4. It may be that the medical insurance account is abnormal and needs to be inquired and handled by the social security department.
Rules for the use of medical insurance funds:
1. Personal account and overall fund: Medical insurance funds are usually divided into two parts: personal account and overall fund. There may be zero balance in the personal account, but the overall fund still has funds;
2. Time difference between payment and reimbursement: after payment, it may take some time for the funds to arrive in the account or be updated and displayed in the personal account;
3. Reimbursement process and limit: Medical insurance reimbursement usually has a certain process and limit, and the excess may not be reimbursed, resulting in a decrease in personal account balance;
4. Conditions for enjoying medical insurance benefits: The enjoyment of medical insurance benefits may be restricted by certain conditions, such as the type of diagnosis and treatment, drug list, etc. , and unqualified expenses cannot be reimbursed;
5. Frozen or abnormal accounts: personal accounts may be frozen or abnormal for various reasons, resulting in zero balance;
6. Impact of policy adjustment: The adjustment of medical insurance policy may affect the balance display of personal accounts, such as adjusting the payment ratio and reimbursement scope.
To sum up, the zero balance of the medical insurance account may be due to the fact that the employees of the company only pay endowment insurance and ignore medical insurance, and pay one-time medical insurance for urban residents. The flexible employees pay low fees and have not established personal accounts, or the medical insurance account itself is abnormal, which needs to be solved by consulting the social security department.
Legal basis:
People's Republic of China (PRC) social insurance law
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.
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.
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