Medical insurance has just been handed in. Can it be reimbursed?

Medical insurance can't be reimbursed when it's just handed in. You can use the medical insurance card and enjoy reimbursement after paying the medical insurance for more than half a year. The medical insurance adopts the pay-as-you-go system. You will be insured for the first time and then after the payment deadline, and you can enjoy reimbursement only after the medical insurance takes effect. There are two conditions for medical insurance reimbursement: one is to have a card, and the other is to pay in the month of reimbursement.

What is the proportion of medical insurance reimbursement?

The proportion of medical insurance reimbursement is 85%. If it exceeds the basic limit, the social security department will reimburse 85% for expenses below RMB 0-40,000, 90% for expenses below RMB 40,000-80,000 and 95% for expenses above RMB 80,000.

The proportion of medical insurance reimbursement varies from region to region and depends on local policies.

1, elderly people over 70 years old. The premise of medical insurance reimbursement is to meet the scope of medical insurance reimbursement, and the medical expenses incurred must be below 654.38+ 10,000 yuan. In a settlement year, a first-class hospital can reimburse up to 65%, and there will be no threshold. The highest reimbursement for secondary hospitals is 55%; In tertiary hospitals, up to 50% can be reimbursed, and the minimum payment standard in 500 yuan is also set.

2. Students or children. The premise of residents' medical insurance reimbursement is to meet the scope of reimbursement, and the medical expenses incurred must be below 6.5438+0.8 million yuan. In a settlement year, the highest reimbursement rate of a first-class hospital is 65%, and there will be no reimbursement and qifubiaozhun. Secondary hospitals can be reimbursed up to 60%; Tertiary hospitals can report up to 55%.

3. Urban and rural residents of other age groups. The premise of residents' medical insurance reimbursement is to meet the scope of reimbursement, and the medical expenses incurred are below 654.38+10,000 yuan. In a settlement year, a first-class hospital can reimburse up to 60%, and there will be no threshold. Secondary hospitals can be reimbursed up to 55%; Third-level hospitals can only reimburse 50% at most.

To sum up, just paying social security for medical treatment cannot be reimbursed. Residents who are insured in the name of individuals do not enjoy medical insurance hospitalization reimbursement for just one month. You must pay for 6 months or 1 year continuously to enjoy medical insurance benefits. Individuals who participate in insurance in their own name will have a waiting period of half a year, during which hospitalization cannot be reimbursed.

Legal basis:

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

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.