What is the use of medical insurance with five insurances and one gold?

Five insurance and one gold medical insurance has the following functions:

1, the medical insurance in the five insurances and one gold is the medical insurance of the medical insurance card that everyone often says. After illness, you can use the medical insurance card for medical reimbursement. The scope of reimbursement is diseases in the medical insurance catalogue, which basically covers common diseases.

2. The specific reimbursement ratio varies according to different local policies. Free medical care is a social security system to protect national staff and provide free medical care and preventive services to those who enjoy it through medical and health departments according to regulations. Unlike social security reimbursement, social security reimbursement is reimbursed from the overall fund account.

Medical insurance reimbursement process:

1. The agent needs to bring relevant materials, including the original ID card, the original medical card, the hospitalization certificate of the hospital, the discharge certificate, the charging documents during hospitalization, the corresponding medical records, inspection reports and other related materials, and apply for reimbursement at the social security agency;

2. After accepting the application, the regulatory authorities will review the application materials received, and after the approval, the settlement and payment will be completed on the same day;

3. The social security agency has passed the examination, and the applicant can receive reimbursement expenses with relevant documents. Under normal circumstances, under the condition of complete information, all the reimbursement work can be completed on the same day, without having to run a few more times.

Matters needing attention in medical insurance reimbursement

1, drug purchase reimbursement

If the insured person needs to reimburse the purchased drugs, he/she needs to bring the medical insurance card to the designated medical institutions or pharmacies for purchase, and the medical expenses can be settled directly by credit card, which is not included in the overall social planning when purchasing drugs. All accounts are settled by personal account, and if the balance of personal account is used up, it can also be paid in cash.

2, outpatient reimbursement

You need to bring the original ID card and the medical certificate issued by the doctor to the relevant departments of the local social security center for processing. Those who meet the requirements after examination can apply directly. However, when the outpatient department reimburses, it is necessary to deduct the amount of the social security personal account in the current year and then check the reimbursement amount.

3, hospitalization reimbursement

When in hospital, the insured person needs to pay the deposit of medical expenses first, and when discharged, he will refund more and make up less. Medical expenses incurred before the hospitalization registration formalities shall not be reimbursed.

To sum up, the medical insurance in the five insurances and one gold is the medical insurance of the medical insurance card that everyone often says. After illness, you can use the medical insurance card for medical reimbursement. The scope of reimbursement is diseases in the medical insurance catalogue, which basically covers common diseases.

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

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.