Job Recruitment Website - Social security inquiry - What should I do if Xiamen medical insurance is broken?
What should I do if Xiamen medical insurance is broken?
1. If the employee's medical insurance is paid by the company, you can still enjoy the preferential treatment of halving the waiting period as long as it is renewed within three months after the break-off; If you renew your insurance for more than three months, you need to pay a certain late fee.
2. If residents' medical insurance is paid by individuals, they can't pay it again this year after breaking off diplomatic relations.
The reimbursement scope of medical insurance mainly includes the following contents:
1, which meets the requirements of general outpatient consultation fees, expert outpatient consultation fees and emergency consultation fees of medical institutions;
2, designated medical institutions general ward bed fee;
3, outpatient decocting fee;
4, designated medical institutions for medical treatment, dispensing or retail pharmacies dispensing medical expenses;
5, in line with the basic medical insurance treatment project, medical service facilities, medication scope and payment standard of medical expenses.
The provisions of the medical insurance payment period are as follows:
1, 25 years for men and 20 years for women;
2. When men retire, the cumulative payment period is less than 30 years, and the cumulative payment period for women is less than 25 years. If the employer and individual employees make up the medical insurance premium at one time according to the regulations, it can be regarded as the expiration of the payment period;
3. The medical insurance of enterprise employees shall be regarded as the actual working years recorded in personnel files. According to the relevant laws and regulations of our country, employees should participate in the basic medical insurance for employees, and employers and employees should jointly pay the basic medical insurance premiums in accordance with state regulations.
To sum up, if you find that medical insurance has been cut off, you must take timely measures to deal with it to ensure that your medical security rights and interests will not be affected.
Legal basis:
Article 27 of People's Republic of China (PRC) Social Insurance Law
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; 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.
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.
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