Medical insurance is paid every year. Why is participation suspended?

Medical insurance shows that the annual suspension of participation may be caused by the following reasons:

1. overdue payment: the medical insurance stipulates the deadline for annual payment. If the medical insurance premium is not paid within the time limit, the system will automatically suspend the insurance status. This means that you will not be able to enjoy the health insurance-related benefits during the suspension period.

2. Insufficient payment amount: If the medical insurance payment amount is insufficient, the system will also suspend the enrollment status. In this case, it is necessary to make up the difference to restore the insurance eligibility.

3. Identity information change: Personal identity information changes, such as name and ID number, but it is not updated in time, and the system may suspend the eligibility for insurance. In this case, it is necessary to contact the medical insurance institution in time, submit the correct identity information, and restore the eligibility for insurance.

4. Other reasons: In addition to the above, there are other special circumstances that may lead to the suspension of medical insurance participation, such as changes in personal medical insurance accounts and policy adjustments. This situation requires consulting medical insurance institutions to understand the specific reasons and take corresponding remedial measures.

Medical insurance reimbursement methods are as follows:

1. Before seeing a doctor: Before seeing a doctor, you need to confirm the type and scope of your medical insurance, choose medical institutions and doctors that meet the medical insurance policy, and ensure that medical expenses can be reimbursed;

2. During medical treatment: during medical treatment, you need to fill in your basic personal information and medical conditions accurately, and provide your medical insurance card and related certification materials to doctors and medical institutions;

3. Reimbursement application: After seeing a doctor, you need to submit an application for reimbursement of medical expenses to the local social insurance management center or medical insurance office, and provide relevant medical expenses bills and supporting materials, such as outpatient invoices, prescription notes, medical records, etc.

4. Reimbursement review: medical insurance institutions review the application for reimbursement of medical expenses, check the information such as expenses and illness, and determine the proportion and amount of reimbursement;

5. Reimbursement payment: After approval, the medical insurance institution will pay the reimbursement amount to the applicant's bank account or medical insurance card.

To sum up, if the medical insurance participation status is suspended, it is suggested to contact the local medical insurance institution in time to understand the specific reasons and take corresponding measures to ensure the legitimate rights and interests.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 23

Employees should participate in the basic medical insurance for employees, and employers and employees should jointly pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.