Wuxi handles the designated medical insurance card

1, scope of use of medical insurance card:

Insured employees can swipe their cards on POS machines with passwords when purchasing medicines in designated hospitals and pharmacies, but they cannot withdraw cash or transfer money.

2, medical insurance card balance query:

Insured employees can inquire about the balance by telephone, or at China Bank Savings Office or designated hospitals and pharmacies in urban areas. You can also log in to the social security inquiry system online.

3, medical insurance card transaction query:

Insured employees can print medical insurance card transaction records with their ID cards and medical insurance to China Bank Savings Office, including expenditure records and consumption records of personal account funds. If you have any questions about the transaction records, you can go to the retail business department of Bank of China.

4, medical insurance card password:

If the insured employees change their passwords, they can make changes by phone, or they can make changes with their ID cards at China Bank Savings Office. If the insured employee forgets his password, he can report the loss of the original password with his ID card to China Bank Savings Office and change it.

5, medical insurance card custody:

Insured employees should take good care of their medical insurance cards. If you accidentally lose it, please immediately issue a letter of proof to the unit and stamp it in the medical insurance office for confirmation. Then, they will take their ID cards to China Bank Savings Office to report the loss and go through the replacement procedures. After 7 days, they can get a new card.

6. Precautions:

When the number of medical insurance card transactions reaches 60, the insured employees must print the transaction records at China Bank Savings Office, or stop using the card. After the transaction record is printed, the card can continue to be used.

In the pharmacy 100% will bear it by itself, and hospitalization can only enjoy the reimbursement ratio (which must be within the scope of medical insurance).

If you are hospitalized in medical insurance coverage, you will be reimbursed 55%-65% according to the actual expenses, such as expenditure 1 10,000.

Use process

Patients with medical insurance cards want to go to the hospital after getting sick, so the process of taking medical insurance cards to designated medical insurance units is as follows:

Hold the medical insurance manual and IC card-register the hospital medical insurance office-verify the card-pay the hospitalization deposit-hospitalization-self-funded items need the patient's approval and signature-cash or IC card settlement Qifubiaozhun and the self-paid proportion-within the overall scope, the hospital pays first-settles and leaves the hospital.

Hospitalization expenses are settled by post-paid service items.

Using medical insurance card in designated hospitals

1. When you go to a designated hospital for medical treatment, you can show your medical insurance card to prove your enrollment and registration. Individuals do not need to pay first and then reimburse, and can directly settle the medical insurance reimbursement with medical insurance and hospitals. Only when the account is settled can the self-funded part be paid with the balance of the medical insurance card or cash.

2. There is a deductible line for hospitalization reimbursement (the deductible line standard is generally 10% of the average annual salary of employees in the city last year), which means that you need to pay the deductible line yourself, and the part that exceeds the deductible line can be reimbursed according to local medical insurance regulations. The reimbursement rate varies from place to place, and different projects in different hospitals are different, about 80%. You can go to the local labor and social security online for details.

explain

function

Medical insurance card is a functional card with a chip, which is used for identity confirmation and personal account payment of medical insurance when visiting a doctor or a pharmacy. For example, the initial password of Wuhan medical insurance card is 1234. ). Medical record is a kind of medical record, which can be used in all designated hospitals in the same city to record medical treatment.

Can social security medical insurance be reimbursed?

The so-called medical insurance hospitalization reimbursement-not after you pay cash first, but when you are hospitalized in a designated medical insurance hospital, you issue a medical insurance card, so that the unified medical insurance settlement system can read the information of the insured and handle the hospitalization number. When you leave the hospital, the medical insurance system will not charge you the "reimbursement" part-the overall payment part.

Outpatient reimbursement

Medical insurance for residents:

In an insurance year, if the general outpatient expenses of insured residents in designated outpatient medical institutions are within 100 yuan (inclusive), the residents' medical insurance fund will pay 30% and individuals will pay 70%; Personal consumption exceeds 100 yuan.

Medical insurance for urban workers:

The personal account on the medical insurance card of the insured person insured by the unit is not paid by himself; The medical insurance card for flexible employees also has a personal account of 15 yuan every month since last year, which can be used to pay outpatient expenses, which is equivalent to outpatient reimbursement (unless the insured belongs to civil servants or the unit has other reimbursement policies).

Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B should be paid 10% first, and then enter the basic medical care. According to the annual number of inpatients (more than 1 threshold fee halved), hospital level (different threshold fees, overall planning,

You can check online on the local social security website. All insured persons, with their ID numbers, enter their ID numbers in "Personal Inquiry" on the homepage of this website, and enter the passwords of ID numbers 12~ 17 as required. After entering, click "Personal Inquiry"-click "Designated Medical Insurance Institution" or "Designated Medical Insurance Pharmacy" to make an inquiry. The website can also inquire about the cardholder's payment, personal account balance and historical consumption.

Content of Wuxi social medical insurance

Redistribution process

At this stage, after the medical insurance card is degaussed and lost, the social security card will be replaced directly according to the regulations. The specific process is as follows:

If it is the same bank before and after card replacement, the process of obtaining social security card:

1, I report the loss to the employee medical insurance card service bank with a valid certificate;

2, street labor and social security service center by the bank's "notice of loss" and my valid documents, accept the application for social security card, the time is 45 working days;

3. After receiving the social security card and injecting capital, the amount in the original medical insurance card will be automatically transferred to the social security card without clearing it.

If the card is not from the same bank before and after the card change, the process of obtaining the social security card is as follows:

1. The amount in the original medical insurance card will not be automatically transferred to the social security card. You need to show your valid certificate to the social security sub-center of the insured area to issue the Notice of Closing the Employee's Medical Insurance Card;

2, with the notice and my valid documents to the original employee health insurance card service bank, for medical insurance card clearance.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.