Which is more reimbursed, social security card or medical insurance card?

The reimbursement amount of social security card and medical insurance card depends on the local medical insurance policy.

On-the-job employees can only be reimbursed for medical expenses exceeding 1800 yuan after seeing a doctor in the outpatient department or emergency department of the hospital, and the reimbursement ratio is 50%; Retirees under the age of 70 can be reimbursed after the medical expenses exceed 1300 yuan, and the reimbursement rate is 70%; Retirees over 70 years old, and medical expenses above 1300 yuan can also be reimbursed, but the reimbursement rate will be increased to 80%. Social security cards are not limited to reimbursement of medical expenses, but can also be used for old-age insurance, job registration, unemployment registration procedures and unemployment insurance claims. When seeking medical treatment in a designated hospital, you can show your medical insurance card to prove your insured identity and registration. Individuals do not need to pay first and then reimburse, because the social security card will be regarded as reimbursement after real-time settlement, and the medical insurance department will not make a second reimbursement.

Influencing factors of reimbursement amount of social security card and medical insurance card;

1. Reimbursement ratio: Medical insurance policies in different regions stipulate different reimbursement ratios, and usually the reimbursement ratios of outpatient and inpatient departments will be different;

2. Drug list: drugs and treatment items in the medical insurance drug list can be reimbursed, while those outside the list cannot be reimbursed or the reimbursement ratio is low;

3. Top line: The medical insurance policy usually has an annual top line, and the part exceeding the top line will not be reimbursed;

4. deductible line: medical insurance policies in some areas have deductible lines, that is, medical expenses can only be reimbursed if they exceed a certain amount;

5. Personal account: the balance of personal account in social security card can be used to pay a certain proportion of medical expenses, which affects the actual reimbursement amount;

6. Level of medical institutions: The reimbursement ratio of different levels of medical institutions may be different, and usually the reimbursement ratio of large 3A hospitals is higher;

7. Special diseases: For special diseases, such as chronic diseases and major diseases, the medical insurance policy may have a higher reimbursement ratio or special fund support.

To sum up, the reimbursement amount and proportion of social security card and medical insurance card depend on the local medical insurance policy, and different people and expense standards have different reimbursement proportions, and social security card can also be used for other insurance matters and applying for unemployment insurance benefits. When you go to a designated hospital for medical treatment, you can settle the account in real time when you show your medical insurance card, and you don't need to pay in advance and then reimburse.

Legal basis:

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

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.