How to use Guangzhou medical insurance card? How to protect medical insurance?

1, scope of use of medical insurance card: When insured employees go to designated hospitals and pharmacies for medical treatment, they can swipe their cards on POS machines with their passwords, but they cannot withdraw cash or transfer money.

2. Inquire about the balance of medical insurance card: Insured employees can inquire about the balance by telephone, or at the Bank Savings Office of China or the designated hospitals and pharmacies in the urban area. You can also log in to the social security inquiry system online.

3. Inquiries about medical insurance card transactions: Insured employees can print medical insurance card transaction records, including personal account payment records and consumption records, at China Bank Savings Office. If you have any questions about the transaction records, you can go to the retail business department of Bank of China.

4. Medical insurance card password: The insured employees can change their passwords by phone or bring their ID cards to the Bank of China Savings Office. If the insured employee forgets his password, he can report the loss of the original password with his ID card to China Bank Savings Office and change it.

5. Custody of medical insurance card: Insured employees should keep the medical insurance card properly. If you accidentally lose it, please immediately issue a letter of proof to the unit and stamp it at the medical insurance office for confirmation, and then report the loss to China Bank Savings Office with your ID card and go through the formalities of replacement. After 7 days, they can get a new card.

6. Precautions: When the number of medical insurance card transactions reaches 60, the insured employees must go to China Bank Savings Office to print the transaction records, otherwise they will stop using the card. After the transaction record is printed, the card can continue to be used.

In the pharmacy 100% will bear it by itself, and hospitalization can only enjoy the reimbursement ratio (which must be within the scope of medical insurance).

If the hospitalization is within the scope of medical insurance, the scope of reimbursement is between 55% and 65% according to the actual amount of expenses incurred, such as 10000 yuan.

Outpatient reimbursement:

1, residents' medical insurance:

In an insurance year, if the general outpatient expenses of insured residents in designated outpatient medical institutions are within 100 yuan (inclusive), the residents' medical insurance fund will pay 30% and individuals will pay 70%; Personal consumption exceeds 100 yuan.

2, medical insurance for urban workers:

The personal account on the medical insurance card of the insured person insured by the unit is not paid by himself; The medical insurance card for flexible employees also has a personal account of 15 yuan every month since last year, which can be used to pay outpatient expenses, which is equivalent to outpatient reimbursement (unless the insured belongs to civil servants or the unit has other reimbursement policies).

Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B should pay 10% first, and then enter the basic medical care. According to the annual number of inpatients (more than 1 threshold fee halved), hospital level (different threshold fees, overall planning,

You can check online on the local social security website. All insured persons, with their ID numbers, enter their ID numbers in "Personal Inquiry" on the homepage of this website, and enter the passwords of ID numbers 12~ 17 as required. After entering, click "Personal Inquiry"-click "Designated Medical Insurance Institution" or "Designated Medical Insurance Pharmacy" to make an inquiry. The website can also inquire about the cardholder's payment, personal account balance and historical consumption.

Expand the data usage process:

(1) When seeing a doctor in a designated hospital, show the medical insurance card to prove the identity and registration of the insured. Individuals do not need to pay first and then reimburse, and medical insurance and hospitals can directly settle the part of medical insurance reimbursement. Only when the account is settled, the self-funded part will be paid by the balance of the medical insurance card or cash.

(2) There is a deductible for hospitalization reimbursement (the deductible standard is generally 10% of the average annual salary of employees in the whole city last year), which means that the money outside the deductible needs to be paid by itself, and the reimbursement ratio varies from place to place, and different hospitals and different projects are different, about 80%. You can go to the local labor and social security online for details.

If a patient with a medical insurance card wants to go to the hospital after getting sick, the process of going to the designated medical insurance unit with a medical insurance card is as follows: When the insured is sick, he can go directly to the local designated medical institution with a medical insurance manual and an IC card. The general process is as follows: holding the medical insurance manual and IC card-going to the hospital medical insurance office to register-checking the card-paying the hospitalization deposit-hospitalization-self-funded items need the patient's consent and signature-using cash or IC card to settle the self-paid part of the deductible standard and the self-paid proportion-the hospital pays the expenses within the overall scope-settling and discharging.

Hospitalization expenses are settled by post-paid service items.

References:

Social medical insurance card _ Baidu Encyclopedia