What should I do if the employee social security stops medical insurance?

After the payment is stopped, the medical insurance function in the social security card will be frozen as a whole, and the medical insurance function will be changed to the self-funded mode at the charge office of each medical institution, and only the funds in the personal account can be used to pay medical expenses. After paying the fee within 3 months, you can go to the medical insurance center for manual reimbursement with the relevant receipt. If the insurance is renewed within 3 months after the interruption of payment, the medical expenses incurred during the interruption of payment shall be paid by the medical insurance pooling fund based on the current medical insurance payment salary. If the insured person interrupts the payment within 3 months, he shall enjoy the basic medical insurance benefits for employees from the date of interruption after renewal. The social security card can be used normally from the date of enjoying the treatment. If the payment is interrupted for more than 3 months, if the insurance is renewed by the unit after renewal, the employee will enjoy the basic medical insurance benefits from the next month; Those who renew their insurance as flexible employees can enjoy basic medical insurance benefits for employees after 6 months. However, the emergency medical expenses incurred by the insured within 6 months in designated medical institutions can also be settled after the treatment takes effect, but only in personal accounts.

I. Consequences of social security payment:

(1) Social security is broken, and medical insurance cannot be reimbursed. When the medical insurance is broken, it will stop, and it cannot be reimbursed during the period. There are two ways after the payment is cut off: first, if the premium is paid within 60 days (including 60 days), the medical insurance reimbursement will be resumed from the month after the payment. (Nothing, nothing, life goes on) Second, if you stop paying for more than three months, there will be a waiting period of six months, and you can resume medical insurance reimbursement the next month after you stop paying for six months. At the same time, the biggest benefit of medical insurance, you must know: medical insurance has been paid for 25 years and can be reimbursed for life until death.

(2) social security is paid off, and pensions are paid less or not. Pension and medical insurance are calculated according to "cumulative" contributions. The pension has been paid for 15 years, and you can only receive the pension after retirement. If it is lower than 15, a one-time supplementary pension is required. Make up enough and enjoy pension benefits; /kloc-if you don't make up for it in 0/5 years, you won't enjoy it. Supplement: Similarly, during the pension payment period, the personal account and payment period are not cleared.

(3) Paying social security will affect buying a house and a car. Some cities require X years of social security to qualify for buying a house, which means that they can't reach the threshold of buying a house without paying social security.

(4) Paying social security will affect children's enrollment, senior high school entrance examination and college entrance examination, and many first-and second-tier cities will implement the point enrollment policy. Points admission refers to points according to household registration, housing, social security payment, etc. , admitted in the order of scores.

Social security payment has little impact on pension and industry and commerce, but it can only be enjoyed if it is paid continuously for one year in the same company, which has the greatest impact on medical insurance. If the social security payment is cut off, you can't enjoy medical insurance. Go to the social security bureau to pay social security in the name of an individual.

Two, for medical insurance, if the consequences of interruption of payment are as follows:

The first file of basic medical insurance: from the next month 1, you can use the personal account balance in medical insurance, but you can't enjoy the medical insurance benefits paid by the medical insurance pooling fund.

The second file of basic medical insurance: from the next month 1, you can't enjoy the medical insurance benefits paid by the medical insurance pooling fund.

The third file of basic medical insurance: from the next month 1, you can't enjoy the medical insurance benefits paid by the medical insurance pooling fund.

If the social security payment is interrupted for less than 3 months, and the insured person has been interrupted for no more than 3 months in the medical insurance year, the continuous insured time before and after the interruption will be calculated together after re-payment.

If the social security payment is interrupted for more than 3 months, the insured person's medical insurance will be recalculated after the annual interruption for more than 3 months. The balance of personal account will not be cleared.

Legal basis:

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

Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should 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.

Article 24 The state establishes and improves the new rural cooperative medical system.

Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.