Job Recruitment Website - Social security inquiry - Is the medical insurance card reimbursed for taking medicine?
Is the medical insurance card reimbursed for taking medicine?
(a) hospitalization expenses;
(two) medical expenses within 7 days before emergency observation and hospitalization;
(three) the medical expenses for special diseases in urban residents' outpatient clinics;
(4) Other expenses that meet the requirements.
Second, the insurance benefits:
1, the urban residents' basic medical insurance fund is mainly used to pay the medical expenses of insured residents for hospitalization and outpatient serious illness and outpatient rescue, and the scope and standard of payment are implemented according to the list of drugs, diagnosis and treatment items and medical service facilities of urban residents' basic medical insurance.
2, Qifubiaozhun (also known as the threshold fee) is the same as the basic medical insurance for urban workers, that is, three-level 980 yuan, two-level 720 yuan and one-level 540 yuan.
3. Management of medical treatment: the residents insured by the basic medical insurance for urban residents shall implement the system of fixed-point first visit and two-way referral. The fixed-point medical institutions for the first visit are community health service centers, specialized hospitals, hospital-store cooperation and secondary and below medical institutions. Some tertiary comprehensive and specialized medical institutions will be identified as designated referral medical institutions. When insured residents seek medical treatment, they should first go to the designated first-visit medical institution. If referral treatment is really necessary due to illness, the designated first-visit medical institution shall issue a referral certificate. Can be transferred to the designated referral hospital for hospitalization, and then transferred back to the designated first-visit hospital after the condition is relatively stable.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
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.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(3) borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
Thirty-first social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.
Medical institutions shall provide reasonable and necessary medical services for the insured.
- Previous article:Social security ratio of government contract workers
- Next article:How to delete spending details from social security card
- Related articles
- If employees are given five insurances, will it affect the company?
- Gaomi city endowment insurance inquiry
- What should I do if the Shenzhen social security card has not been paid for several months because of changing jobs? Will the social security card be invalid if it is not renewed for a long time?
- How to buy medicine for the first time with social security card?
- How to pull the social security payment details
- How to query the balance of social security pension?
- Can social security transferred from other places be counted as local?
- Dezhou social security bureau medical insurance card
- Certificate of name change
- A sole proprietorship enterprise pays its own social security.