Scope of use of Zhongshan medical insurance card

Insured employees can swipe their cards on POS machines with passwords when purchasing medicines in designated hospitals and pharmacies, but they cannot withdraw cash or transfer money. That is, the scope of use of urban medical insurance cards is also applicable to the scope of use of rural medical insurance cards. 1. The medical insurance of designated pharmacies consists of two accounts: individual account and overall account. Personal accounts can be used to buy medicines at designated pharmacies, and are mainly responsible for the payment of outpatient expenses and hospitalization expenses. The overall account managed by the medical insurance center pays the expenses incurred by the insured who meet the local medical insurance reimbursement. 2. Designated hospitals (1) produce medical insurance cards to prove the identity and registration of the insured when seeking medical treatment in designated hospitals. Individuals do not need to pay first and then reimburse, and medical insurance and hospitals can directly settle the part of medical insurance reimbursement. Only at the time of checkout, the self-funded part will be paid by the balance of the medical insurance card or cash. (2) There is a deductible for hospitalization reimbursement (the deductible standard is generally 10% of the average annual salary of employees in the whole city last year), which means that the money above the deductible needs to be paid by itself, and the reimbursement ratio varies from place to place, and different hospitals and different projects are different, about 80%. You can go to the local labor and social security online for details. In short, no matter which city in China uses the medical insurance card, such as Shanghai, Guangzhou and Beijing, it is the same, that is, designated pharmacies and hospitals. The biggest difference between the two is the deductible line of hospitalization reimbursement, and the reimbursement ratio varies from place to place, which means that different hospitals and different projects are different.

Legal objectivity:

The Interim Measures for the Fixed-point Management of Medical Security in Retail Drugstores stipulates that designated medical institutions are the general name of designated medical institutions (designated hospitals) and designated retail pharmacies (designated pharmacies), referred to as "two designated institutions" for short; Refers to hospitals and pharmacies that sign service agreements with medical security administrative departments and medical insurance agencies in the overall planning area to provide medical services for the insured persons of basic medical insurance. For the insured, under normal circumstances, only in the "two fixed" medical institutions to see a doctor, buy medicine, in order to get medical insurance reimbursement.