How to inquire about the scope of medical insurance reimbursement

1, social security center query

If you don't know your social security account number, you can bring your ID card to the business hall of social insurance agencies in various districts to inquire;

2. Online inspection

Log in to the city's labor security network or social insurance business website, click the "personal social security information inquiry" window, enter my ID card and password, and inquire about my insurance information;

3. Telephone consultation

Call the labor and social security comprehensive service telephone number "12333" for policy consultation and information inquiry;

4. Touch screen query

If there is a social insurance touch screen inquiry system in the business hall of social insurance agencies in each district, swipe your card or enter the card number or ID number according to the screen prompts for inquiry.

Proportion range of medical insurance reimbursement

1, outpatient and emergency medical expenses: the medical expenses of employees that meet the basic medical insurance coverage in one year exceed 2,000 yuan;

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan;

3, the insured should be properly kept in the designated hospital outpatient medical documents, as a medical expense reimbursement certificate;

4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement;

5. Hospitalization.

After paying medical insurance for 20 years, you can enjoy medical insurance reimbursement after retirement.

To sum up, with medical insurance, although you can't fully reimburse your illness treatment expenses, you can reimburse a large part, which still plays a great role in the sick people and reduces the economic burden of your family.

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.