Job Recruitment Website - Social security inquiry - Can stomatological hospital use medical insurance card?
Can stomatological hospital use medical insurance card?
First of all, people who receive dental treatment in designated medical insurance hospitals can get medical insurance reimbursement.
Secondly, when the stomatological hospital is reimbursed for medical treatment, only filling teeth, extracting teeth and treating gum diseases can enjoy medical insurance reimbursement. Finally, stomatological hospitals designated by medical insurance can use medical insurance cards for medical treatment. The insured person can register with the designated medical institution in the insured place with the medical insurance card and go to the stomatology department to see the dentist. The medical expenses incurred by filling teeth belong to the expenses paid by the medical insurance fund, which can be paid directly by swiping the medical insurance card. However, dental implants and dental implants belong to the category of medical beauty. You can't pay by medical insurance card, but you need to pay in cash. The medical insurance card can reimburse the cost of going to the dentist, but there are strict regulations on the reimbursement of dental expenses. Only therapeutic dental treatment can be reimbursed by medical insurance, such as filling teeth, extracting teeth and treating periodontal disease and gingivitis.
Medical insurance card (hereinafter referred to as medical insurance card) is a special card for personal account of medical insurance. It takes personal ID card as the identification code, and stores detailed information such as personal ID card number, name, gender, payment, account fund consumption, etc. The medical insurance card is undertaken by the local designated agent bank, which is a multi-functional debit card of the bank.
On-the-job employees who participate in comprehensive medical insurance, 90% of their basic medical expenses during hospitalization are paid by the basic medical insurance pooling fund, and the individual pays10%;
For retirees who participate in comprehensive medical insurance, 95% of the basic medical expenses during hospitalization are paid by the basic medical insurance pooling fund, and 5% is paid by individuals, unless otherwise stipulated in these Measures.
The basic outpatient medical expenses of the insured person of comprehensive medical insurance and the expenses of drugs and diagnosis and treatment items using the local supplementary medical insurance drug list in outpatient service shall be paid by the personal account; Personal account is insufficient to pay, outpatient basic medical expenses by the basic medical insurance fund to pay 70%, individuals pay 30%.
To sum up, when the insured person of comprehensive medical insurance goes out to see a doctor, due to illness, after being approved by the municipal social insurance institution or its authorized medical institution, he will do large-scale medical equipment inspection or treatment in the outpatient department, and the expenses will be paid by the basic medical insurance pooling fund 80%, and the individual will pay 20%. Large medical equipment inspection items and treatment items are determined by the municipal social insurance institutions.
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.
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