How to report the current medical insurance?

Legal analysis: 1. First of all, when the insured person goes to see a doctor, he will write a prescription and pay the fee after taking the social security person to see a doctor. The insured person goes to the doctor with the registration form, and the doctor registers the insurance card at the registration office.

2. After the insured person takes the prescription to the hospital settlement window for pricing, he can directly brush the social security card to pay the medical expenses within the scope of medical insurance fund payment. If some drugs in the prescription are not covered by the medical insurance fund, the insured person needs to pay cash.

3. The social insurance plan is organized by the government, forcing a certain group to use part of its income as social insurance tax (fee) to form a social insurance fund. Under certain conditions, the insured can get fixed income or loss compensation from the fund. It is a redistribution system, and its goal is to ensure the reproduction of material and labor and social stability.

Social security includes medical insurance, and medical expenses reimbursement methods of medical insurance:

(1) outpatient medical expenses reimbursement: outpatient family account is reimbursed by households, and the total amount is calculated according to each person 10 yuan and the number of indoor participants. Within the total reimbursement limit, the whole family can use the outpatient service according to the standard of 40 yuan/person/year, and the compensation ratio is 30% each time. Outpatient care is people-oriented, and family members are not adjusted. Out-of-county outpatient expenses will not be reimbursed temporarily.

(2) Reimbursement of hospitalization medical expenses: reimbursement according to the deductible line, reimbursement according to the prescribed proportion, and cumulative reimbursement capping management. After removing the self-funded items, the medical expenses below the deductible standard are paid by the patients themselves, which is in line with the scope of reimbursement. The first-level hospital hospitalization deductible line 50 yuan, the compensation ratio is 75%, the second-level hospital hospitalization deductible line 300 yuan, the compensation ratio is 45%, and the third-level hospital hospitalization deductible line 1000 yuan, the compensation ratio is 20%. Chinese medicine services will be increased by 10 percentage point on the basis of the compensation ratio of similar designated medical institutions. The maximum amount of accumulated reimbursement per person for the whole year is 30,000 yuan.

(3) reimbursement of outpatient medical expenses for chronic diseases: according to the father's situation, it can be regarded as a patient with chronic diseases, and the outpatient medical expenses for the month of hospitalization due to illness will be deducted within one year. If the total remaining expenses exceed 150 yuan, the diagnosis certificate of chronic diseases, outpatient invoices, prescriptions, inpatient outpatient medical records, household registration books and medical certificates that I applied for in designated hospitals shall be submitted to township hospitals or central hospitals for review before June 30th of that year 165438+, and to county hospitals before June 65438+February 10. The deductible line is 150 yuan, and the compensation ratio is determined by the county joint management office according to the incidence of chronic diseases in the county.

To sum up, social security is to ensure that the insured can get corresponding protection when he is injured and unemployed. When he wants to submit an expense account, he needs to go to the window with the relevant documents. There are also upper and lower limits on the amount of reimbursement, and he will reimburse according to the specific situation.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.