Proportion of medical insurance reimbursement in Shenzhen

Legal analysis: the proportion of hospitalization reimbursement of Shenzhen social security;

1. If you are hospitalized in a designated hospital in Shenzhen outside the city (about 80%), you can swipe your card directly. If you are hospitalized in a designated hospital in Shenzhen outside the city (such as Guangzhou 12 Shenzhen Social Security Hospital), (60%-75%), you can pay in advance and then reimburse in depth.

2. If you are hospitalized in a non-Shenzhen designated hospital outside the city, you will be reimbursed at your own expense. With relevant information, I went back to Shenzhen to reimburse Qi Qiaoque (detailed materials are needed later). The second and third grade ratio (60%) and the third grade ratio (45%-55%).

If you stop paying social security and then renew it, if you don't stop paying halfway, it doesn't matter and it doesn't affect the use. If the payment is interrupted and re-paid, it will have an impact on medical insurance, maternity insurance and unemployment insurance.

If you continue to pay after disconnection, the medical insurance paid by the unit will not enjoy the medical insurance benefits until next month 1, and individuals will have to wait for 3 months to enjoy the medical insurance benefits; Unemployment and maternity insurance need to be paid continuously for more than 1 year to enjoy medical insurance benefits.

If it is comprehensive medical insurance or hospitalization medical insurance, go to the social security bureau for filing after issuing the transfer certificate, and then go to the hospital after filing, and 90% of medical insurance can be reimbursed; If you don't transfer your old hospital, the number of hospitals belonging to Shenzhen social security card designated hospitals will drop by 20%, that is, 90%×( 1-20%)0%×80%2%. If the hospital belongs to the designated hospital in Shenzhen, you can also swipe the social security card in Shenzhen if it is not transferred to the record. Of course, it is also limited to comprehensive medical insurance or hospitalization medical insurance.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

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

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.