Job Recruitment Website - Social security inquiry - How to use non-deep household medical insurance

How to use non-deep household medical insurance

Legal analysis: 1, the money reflected in personal accounts and medical insurance cards can be used to buy medicines at designated pharmacies, pay outpatient expenses and pay the out-of-pocket part of hospitalization expenses; 2, the overall account, managed by the medical insurance center, the insured in line with the scope of local medical insurance reimbursement costs paid by the overall account.

Legal basis: Non-deep households can also use the medical insurance card to see the Shenzhen Social Medical Insurance Measures. In the past, hospitalization insurance was mostly attended by non-deep households, and the medical insurance card could not see the outpatient service. See below for specific provisions.

Under the condition that the payment standard of hospitalization medical insurance remains unchanged, each person will withdraw 6 yuan from the hospitalization medical insurance premium every month to establish the outpatient medical fund. The outpatient medical treatment, medical treatment procedures, settlement methods and service management of inpatient medical insurance for the insured shall be implemented with reference to the relevant provisions of medical insurance for migrant workers in our city; The outpatient medical treatment and hospitalization of medical insurance participants remain unchanged.

Outpatient (including emergency) expenses incurred by migrant workers' medical insurance and inpatient medical insurance participants in the selected community health centers shall be dealt with according to the following provisions: those belonging to Class A and Class B drugs in the basic medical insurance catalogue shall be paid by the community outpatient co-ordination fund according to the proportion of 645, 458 and 60% respectively. 2, belongs to the basic medical insurance directory of medical items or medical consumables, personal price is lower than 1200 yuan, by the community outpatient co-ordination fund to pay 90%; If the personal price exceeds 120 yuan, it will be paid by the community clinic as a whole fund 120 yuan. 3, the insured approved by the settlement hospital referral to other designated medical institutions of outpatient medical expenses, or emergency medical expenses in non settlement hospitals, by the community outpatient co-ordination fund in accordance with the provisions of the first and second items of this article, 90% reimbursement. (3) The outpatient medical expenses of the insured who are referred to other designated medical institutions with the approval of the settlement hospital, or the emergency medical expenses incurred in non-settlement hospitals, shall be reimbursed by the community outpatient co-ordination fund in accordance with the provisions of items 1 and 2 of this article. The outpatient medical expenses (including emergency) paid by the community outpatient fund to each insured person in a medical insurance year shall not exceed the maximum of 800 yuan.