Can social security and rural cooperative medical insurance be reimbursed at the same time?

First, social security and rural cooperative medical insurance can be reimbursed at the same time, not at the same time, only one of them can be reimbursed.

Two, the new rural cooperative medical insurance is one of the branches of social security medical insurance, social security includes pension insurance, medical insurance, unemployment insurance, maternity insurance, work injury insurance, etc. , collectively referred to as the five risks. The new rural cooperative medical system and social security are inclusive and cannot be compared.

If a party participates in more than two branches of social security medical insurance at the same time (employee medical insurance, flexible employment medical insurance, urban residents medical insurance and new rural cooperative medical system), only one of them can be used for reimbursement.

Three, medical insurance hospitalization social security reimbursement matters needing attention:

1. Reimbursement scope: hospitalization expenses incurred by the insured in designated hospitals or specialized hospitals, Chinese medicine hospitals and 3A hospitals selected by the individual.

2. Inpatient deductible line: The standard of the first hospitalization deductible line in a natural year is 1.300 yuan, with 650 yuan as the unit each time.

3. Reimbursement ratio: 90% in the first-class hospital, 87% in the second-class hospital and 85% in the third-class hospital, with a total reimbursement of 300,000 yuan for hospitalization.

4. Handling process: Please use the Shenzhen Medical Insurance Manual for medical treatment. If the unit pays in full, the individual can go through the hospitalization formalities only by paying part of the hospitalization advance payment, and the medical expenses incurred should meet the scope of medical insurance. When leaving the hospital, the hospital and the individual will settle the expenses themselves, and the reimbursement amount of the overall fund will be settled by the hospital and the district medical insurance center.

Extended data:

First, medical insurance outpatient reimbursement matters needing attention:

1. Use the medical insurance card to see a doctor in the outpatient department, and settle the account in real time without reimbursement.

2. Please use the Shenzhen Medical Insurance Manual to go to the clinic without a medical insurance card.

(1) Reimbursement scope: general outpatient and emergency expenses incurred by the insured in designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and 3A hospitals selected by the insured.

(2) Outpatient deductible line: the total emergency expenses of general outpatient service in a natural year exceed 1.800 yuan.

(3) Reimbursement ratio: 70% for the hospital and 90% for the community, and 20,000 yuan for the part above 1.800.

(4) required materials:

Original ID card; Original medical diagnosis certificate; Original medical data such as outpatient medical records, examination and test results reports; Original receipt of general outpatient and emergency charges, detailed list of outpatient expenses or original prescription (the prescription is attached to the receipt by date).

(5) Handling process: If the accumulated Qifubiaozhun exceeds the Qifubiaozhun in a natural year, the unit manager will input all the documents into the enterprise software and report the generated electronic information and statements to the medical insurance center, which will complete the review, settlement and payment of reimbursement expenses within 30 working days.

Second, social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection.

(1) Composition of social overall medical insurance: the payment base is m: wage income of employees+allowance. The unit pays 8% every year; Individual employees pay 2% every year;

The unit pays 8%: 6.6% to 7% belongs to the overall account (1% to 1.4% belongs to the personal account)-hospitalization expenses;

2% m: 2% m of the salary paid by the individual goes into the personal account (plus the unit payment 1%M to 1.4% M)- outpatient expenses.

Note: hospitalization expenses are reimbursed from the overall account, and the amount is the same for everyone; Outpatient expenses are deducted from personal accounts (that is, medical insurance cards), and everyone is different.

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