What does the medical insurance red list mean?

The medical insurance red list refers to the list of people who enjoy medical insurance benefits. There are also red lists and blacklists in the hospital. In the blacklist, the social security card cannot be settled in real time, but is on the red list.

Reasons why medical insurance is not on the red list:

1, the unit or individual has not paid the social security fee, and it is in a state of termination;

2. If the unit or individual fails to pay the fee on time, the system will automatically stop using the social security card;

3. The automatic payment of affiliated banks is suspended due to system or other reasons;

4. Social security should be paid on time on a monthly basis, and individual cases can be reimbursed manually if they are no longer red.

The solution to the problem that medical insurance is not on the red list;

1. I was told that I was not on the red list, so the medical expenses incurred this time could not be settled in real time with my card, but the insured still had to show his social security card when registering for payment. The hospital collects relevant information according to the social security card and uploads it, and issues a charging bill with the logo of "medical insurance has been settled in real time" (arrears) or a charging bill with the upload logo;

2. First, the medical expenses are paid in full by the individual. After the red bill is restored, the applicant will submit the reimbursement manually to the medical insurance center in the district.

To sum up, when the social security card can't be used normally, the staff in the service window of the hospital will issue a notice of medical treatment with the social security card, and the medical insurance object will go to the nearest street (township) social security card service station to check the card with the notice, or go to the nearest district/county social security card service station to check and change the card. When the medical insurance card can not be used normally, it should be checked and replaced at the nearest district and county medical insurance affairs center.

Legal basis:

Article 28 of People's Republic of China (PRC) 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.