The new social security card is activated, but it cannot be used.

There may be three reasons for activating or not using the social security card:

1. The social security card cannot be used. Maybe there is no money in the social security card.

2. The social security card cannot be used and may be damaged.

3. The social security payment is interrupted, and the medical insurance function of the social security card cannot be used normally.

1. What can medical insurance reimburse?

1, drug reimbursement for basic medical insurance

Drugs included in the basic medical insurance payment range are divided into Class A and Class B ... Class A drugs refer to drugs that are basically unified throughout the country and can ensure the basic needs of clinical treatment. The expenses of such drugs are included in the payment scope of the basic medical insurance fund, and the expenses are paid according to the basic medical insurance payment standard.

The list of Class B drugs shall be adjusted by all provinces, autonomous regions and municipalities directly under the Central Government according to their own conditions. Before such drugs are included in the payment scope of the basic medical insurance fund, the employees shall pay according to a certain proportion and pay according to the basic medical insurance payment standard.

The following drugs do not belong to the basic medical insurance reimbursement scope:

(1) drugs with nourishing and strengthening effects;

(2) Some animals and animal organs and dried fruits that can be used as medicine;

(3) Various wine preparations brewed with Chinese herbal medicines and Chinese herbal pieces;

(4) Fruity preparations and oral effervescent agents in various medicines;

(5) Blood products and protein products (except for special indications and first aid and rescue);

(six) other drugs that are not paid by the basic medical insurance fund as stipulated by the administrative department of social insurance.

2, the basic medical insurance treatment project reimbursement

The basic medical insurance treatment project shall meet the following conditions:

(1) Clinical diagnosis and treatment must be safe and effective, and the cost should be appropriate;

(2) The price department has set the charging standard;

(3) within the scope of designated medical services provided by designated medical institutions for the insured.

The scope of basic medical insurance to pay part of the cost of diagnosis and treatment projects is determined in accordance with the scope of basic medical insurance diagnosis and treatment projects stipulated by the state. Belong to the basic medical insurance payment part of the directory of medical treatment project costs, first by the insured according to the provisions of the proportion of self pay, and then pay according to the provisions of the basic medical insurance. Belonging to the basic medical insurance for employees, belonging to the catalogue of medical treatment projects that are not paid, the basic medical insurance fund for employees will not pay.

3. Reimbursement of basic medical service facilities

The reimbursement scope of medical service facilities in the basic medical insurance includes the living service facilities provided by designated medical institutions and necessary for the insured to receive diagnosis, treatment and nursing, mainly including the hospitalization bed fee or outpatient (emergency) observation bed fee.

The basic medical insurance fund does not pay for living services and service facilities, mainly including:

(1) outpatient and first aid (transfer) transportation expenses;

(2) Air conditioning fee, TV fee, telephone fee, baby incubator fee and food incubator fee;

(3) Escort fee, nursing fee, washing fee and outpatient decocting fee;

(4) meals;

(5) Hospitality and other special life service expenses.

Second, what is the reimbursement rate?

After excluding non-reimbursable expenses, the reportable expenses are discounted according to different levels of medical institutions: township hospitals in this city 100%, municipal hospitals in this city 90%, outside the city 80%, and 60% without referral certificate. After the discount, the expenses will be settled in proportion: 45% will be reimbursed within 4000 yuan; 400 1-8000 yuan will be reimbursed by 55%; 800 1- 12000 yuan will be reimbursed by 65%; 12001-20,000 yuan will be reimbursed by 75%; More than 20 thousand yuan will be reimbursed 80%. The maximum amount of compensation per person per year shall not exceed 30,000 yuan.

3. What materials are needed for reimbursement of medical expenses? What are the procedures and processes?

(a) the required materials are:

1, original hospitalization invoice;

2. Discharge record;

3, medical expenses list or doctor's advice (provided by the hospital);

4. My identity certificate (copy of ID card or household registration certificate);

5. Others (recommendation certificate, work place certificate, etc.). ).

(2) Procedures and formalities

Patients hospitalized in this city shall directly settle hospitalization expenses in designated medical institutions; For the hospitalization expenses transferred from outside the city, 1 month, the above materials shall be submitted to the handling personnel of township hospitals (joint management office) for settlement, and then sent to the municipal medical insurance office for settlement after preliminary examination.

4. Do you need to go through the examination and approval or registration procedures for hospitalization? How to deal with it

Participants in the city designated medical service institutions (hospitals) hospitalization without any formalities. However, if it is necessary to go outside the city for treatment due to illness, the attending doctor shall fill in the diagnosis of the disease and the medical institution's medical insurance office shall examine and approve it. Report to the municipal joint management office for reference. The emergency shall be handled according to the prescribed procedures within ten days.

Verb (abbreviation of verb) How to reimburse the medical expenses of migrant workers?

Migrant workers in hospital, in addition to providing hospitalization invoices, discharge records, medical expenses list (or doctor's advice), identification, but also need to provide proof of employment in the workplace (which can be provided by the neighborhood Committee or factory in the workplace). Otherwise, according to the proportion of no referral certificate settlement.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services.

Fifth people's governments at or above the county level shall incorporate social insurance into the national economic and social development plan. The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance. The state supports social insurance through preferential tax policies.