Physical examination can use the social security card, reimbursement range of what

Social security card for our life plays a great role, social security in the health insurance card is money, if we go to the hospital to see a doctor or to go to the designated pharmacy to buy drugs, it is possible to use the money in the, many people may ask so the medical examination can be used with the social security card, the reimbursement scope of which? The following is a detailed introduction, I hope to help you. A, physical examination can use social security card

Physical examination can be used with social security card, the person's social security card is for the individual's health to pay for the service. The physical examination usually needs to go to the hospital checkup center, health management center for physical examination procedures. Medical checkups for civil servants usually take place once a year, including checkups for division-level cadres, section-level cadres, and general public employees. Individuals can also choose some medical checkups by themselves by fully communicating with their doctors, such as blood sugar, blood lipids, liver function, kidney function, electrocardiogram, chest front and side view film, ultrasound examination of liver, gallbladder, pancreas, spleen and kidney, and so on. The social security card is mainly for personal physical examination for consumption, if it is the parents, friends of the physical examination, can not brush their social security card, social security card can only be used in person.

Two, social security card reimbursement scope of what

1, the basic medical insurance drug reimbursement

China's drug categories can be divided into Class A, Class B and Class C, Class A girdle of the basic into the medical insurance fund to pay the scope of the reimbursement in accordance with a certain standard; B drugs reimbursement of 80%, the other 20% of the self-reported; Class C drugs For self-contained drugs, not reimbursed.

The following medicines are not covered by the basic health insurance:

(1) the main role of nutritional tonic medicines;

(2) part of the animal and animal organs can be used as medicine, dried (water) fruit;

(3) with Chinese herbs and Chinese medicinal herbs and tablets of all kinds of wine preparations;

(4) all kinds of medicines in the fruit-flavored preparations, oral effervescent agent;

(5) blood products, Protein products (except for special indications and first aid, rescue);

(6) social insurance administrative department stipulates that the basic medical insurance fund does not pay for other drugs.

2, basic medical insurance reimbursement

basic medical insurance treatment program should meet the following conditions:

(1) clinical diagnosis and treatment must be, safe and effective, the cost is appropriate;

(2) by the pricing department to set the charges;

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

3. Reimbursement of basic medical service facilities

The reimbursement of basic medical insurance medical service facilities covers the living service facilities provided by the designated medical institutions, which are necessary for the participants in the process of receiving diagnosis, treatment and care, including inpatient hospitalization beds or outpatient (emergency) hospitalization beds.

Article 8 of the Rules for the Implementation of the Social Insurance Law of the People's Republic of China

The medical expenses incurred by the insured in the agreed medical institutions, which are in line with the standards of the basic medical insurance drug catalog, diagnostic and therapeutic items, and medical service facilities, shall be paid out of the basic medical insurance fund in accordance with the state regulations. Participants in need of emergency treatment, rescue, can be in non-agreement medical institutions; must be used for rescue drugs can be appropriately relaxed. Participants in the emergency, rescue medical services specific management by the coordinating region in accordance with the actual situation of the local development.

Three, social security card reimbursement settlement is how

1, in the use of social security card before, has occurred outpatient medical expenses, how to reimbursement as well as outpatient registration and consultation fees are reimbursed proportionally?

Before using the social security card, has occurred outpatient medical expenses, handed over to the unit or the social security institute in accordance with the original process of reimbursement, if you have used the social security card to seek medical treatment, you need to hand over the social security card at the same time; since June 1, 2009, outpatient consultation and treatment fees by the health insurance fund fixed payment of 2 yuan, the rest of the cost of the insured person by the cash payment. It is worth stating that, regardless of whether the medical costs incurred by the patient exceeds the outpatient starting line, the health insurance fund will also pay a fixed amount of 2 yuan.

2. Are the medical expenses for purchased medicines settled in real time with the card?

The medical expenses incurred for purchased medicines are not settled in real time with the card, and are still operated according to the original settlement method.

3. What are the special circumstances under which a participant can be reimbursed for the full amount of cash advances for medical expenses?

In case of emergency without a social security card, family planning surgery, business arrears, manual reimbursement or replacement of social security cards during the period of participation in the social security card is not issued after the case of medical treatment, the participants are still by the individual cash full advance of medical expenses, can not be completed directly in the hospital real-time settlement, in line with the conditions of payment of the health insurance fund to be in accordance with the original process for manual reimbursement procedures.

4, how to read the real-time settlement fee bill?

(1) The real-time settlement of the fee bill details, the amount of health insurance coverage can be included in the total amount of health insurance payments.

(2) The medical insurance fund to pay: in accordance with the policy should be paid by the medical insurance fund total costs, including outpatient large medical, retiree supplemental insurance, disabled military benefits.

(3) "this personal burden" of medical costs include three parts:

1 out-of-pocket one: the proportion of the individual should bear the medical costs (including the starting line and the amount above the ceiling line);

2 out-of-pocket two: the amount of Category B directory needs to be borne by individuals (such as Category B drugs in the individual out-of-pocket payment of 10% of the cost of medical care);

3 out-of-pocket: reimbursement (i.e., medicines, diagnosis and treatment, services and facilities three catalogs);

3 out of pocket: reimbursement (that is, medicines, treatment, services and facilities three catalogs),

(4) The total medical expenses of the current visit = the medical insurance fund payment + the personal burden.

The above is to introduce you to the "medical examination can use the social security card, reimbursement scope of what" the relevant legal knowledge. In summary, the social security card can be used in the medical examination above, but the social security card is limited to the use of myself, can not be given to others to use.