Job Recruitment Website - Social security inquiry - Changing the unit's medical insurance was cut off for a month.
Changing the unit's medical insurance was cut off for a month.
A month away from medical insurance has an impact. The insured units and insured persons who stop paying medical insurance premiums shall stop enjoying the medical insurance benefits paid by the medical insurance pooling fund from the next month 1 day after the interruption of payment, but the balance of their personal accounts can continue to be used. When the insured person resumes the insurance formalities, he can enjoy the prescribed medical insurance benefits from the next month 1 day after paying the medical insurance premium.
What does the reimbursement scope of medical insurance generally include?
1. List of medical insurance drugs: The list of medical insurance drugs is generally divided into Class A and Class B. All Class A drugs are included in the scope of reimbursement, and then reimbursed according to the prescribed proportion. Class B drugs need to pay a certain proportion first, and the rest are included in the scope of reimbursement, and reimbursed according to a certain proportion. And some drugs can not be reimbursed, such as: diet pills, infertility and other drugs;
2. Catalogue of diagnosis and treatment items: all the necessary, safe, effective and appropriate diagnosis and treatment items in clinical diagnosis and treatment, and the fees are customized by the price department, can be reimbursed. Other items can not be reimbursed, such as registration fee, plastic surgery, dental beauty, etc.
3. Catalogue of medical-related service facilities: generally provided by designated medical institutions. The insured generally needs to receive necessary service facilities during the process of diagnosis, treatment and nursing.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid by the basic medical insurance fund according to state regulations. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.
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