Do you need a medical insurance card for medical insurance reimbursement?

First of all, no medical insurance card can be reimbursed. The following conditions are required:

I. Reimbursement conditions:

Medical insurance must be paid continuously for more than three months, and it will not take effect until the fourth month, and the related medical expenses can be reimbursed.

After the medical insurance comes into effect, the company can go to the local social security department to apply for a medical card without hospitalization certificate.

If the medical insurance card is not received, individuals can also apply for reimbursement of medical expenses after hospitalization. Individuals can submit relevant materials to their medical insurance center for reimbursement.

Under normal circumstances, if an individual does not receive a medical insurance card, he can go to the medical insurance center to make a temporary card for medical treatment, which is convenient for medical treatment.

Second, the information required for reimbursement:

When applying for reimbursement, you should bring hospital invoices, general list, doctor's advice, medical records and other materials.

You can see a doctor first, and then go to the medical insurance center for manual reimbursement. Reimbursement expenses will be directly credited to the designated bank card.

Third, the scope of reimbursement:

1, medical insurance card reimbursement is limited to medical expenses above hospitalization caused by diseases and some accidents in re-designated hospitals.

The formula for reimbursement is: (total expense-threshold expense-self-funded expense-expense overrun) *(75+ age *0.2)% Generally, the actual reimbursement ratio is between 20% and 60%.

Self-funded drugs are not reimbursed, class B drugs are reimbursed 80%, bed fees are limited, and some inspection fees and treatment fees are not reimbursed according to regulations.

2. The reimbursement amount of medical insurance card is 4 times of the local social wage (1 year cumulative value).

3. The money in the medical insurance card can be used to buy medicines at designated pharmacies and pay for outpatient and emergency expenses, but it does not belong to the category of reimbursement, because the money in the medical insurance card is the money in the medical insurance personal account.

When applying for reimbursement, you should bring hospital invoices, general list, doctor's advice, medical records and other materials. You can see a doctor first, and then go to the medical insurance center for manual reimbursement. Reimbursement expenses will be directly credited to the designated bank card.

Legal basis:

People's Republic of China (PRC) (China) Basic Medical Care and Health Promotion Law

Eighty-second basic medical service fees are mainly paid by basic medical insurance funds and individuals. The state raises basic medical insurance funds through various channels according to law, and gradually improves the mechanism of sustainable financing and adjusting the level of basic medical insurance protection.

Citizens have the right and obligation to participate in basic medical insurance according to law. Employers and employees pay basic medical insurance premiums for employees in accordance with state regulations. Urban and rural residents pay the basic medical insurance premiums for urban and rural residents according to regulations.