Shenzhen second gear medical insurance can buy drugs in the pharmacy?

Shenzhen second-ranking medical insurance can not buy drugs in the pharmacy, the second-ranking medical insurance does not have an account balance, can not be used in the pharmacy, first-ranking medical insurance can be used in the pharmacy, but also more than a certain balance (accumulated amount of more than the city's average annual salary of on-the-job workers 5%) before you can use.

Where can I buy drugs with my second-tier health insurance?

People with second-tier health insurance cards can go to the bound community health center to see a doctor and buy medicine, and can directly swipe their health insurance cards to settle the bill.

Shenzhen medical insurance contribution standards

Different employees to participate in the first class of medical insurance, to the employee's monthly gross salary of 8.2% or 7.2% of the standard monthly contributions, of which the employer to pay 6.2% or 5.2%, the individual to pay 2%. The second class of medical insurance contribution base for the average monthly salary of employees on the job in Shenzhen in the previous year, the contribution rate of 0.8% (basic medical insurance + local supplementary medical insurance), of which the unit to pay 0.6%, individuals pay 0.2%. That is to say, to pay the second grade of medical insurance each month, individuals need to pay 11620 yuan × 0.2% = 23.24 yuan. The third grade of medical insurance contribution base for the average monthly salary of on-the-job workers in Shenzhen in the previous year, the contribution rate of 0.55% (basic medical insurance + local supplementary medical insurance), of which the unit to pay 0.45%, individuals pay 0.1%. That is to say, to pay the third grade of health insurance each month, individuals need to pay 11620 yuan × 0.1% = 11.62 yuan

Principle of medical treatment

The first grade of the participants: the city of any certain point of care medical institution for medical treatment. Participants in the second class: outpatient treatment at the bound community health center, inpatient treatment at any designated medical institution in the city, and outpatient treatment for major diseases at the prescribed medical institutions. Third-tier participants: outpatient treatment at the bound community health center, inpatient treatment and outpatient treatment for major diseases at the prescribed medical institutions. This is also what people ask about more, the first class of participants (whether they are deep households or non-deep households), can go to any designated medical institutions in the city, outpatient and hospitalization reimbursement by credit card. The second class of participants (regardless of whether they are deep households or non-deep households), is to go to the bound community health clinic to see the outpatient, if it is hospitalized, it is possible to go to any designated medical institutions in the city. The third-rate participants, whether outpatient or hospitalized, are to go to the bound medical institutions Oh.

General outpatient treatment of the first class of participants: personal account for the payment of participants in the general outpatient medical insurance catalog within the scope of medical expenses. The basic medical expenses of the social health center, 70% paid by the individual account, 30% by the integrated fund in accordance with the provisions of the payment. Second-tier participants/third-tier participants: for drugs belonging to Class A and Class B, 80% and 60% respectively are paid by the community outpatient coordinated fund; for single diagnosis and treatment or medical materials belonging to the medical insurance catalog, 90% is paid by the community outpatient coordinated fund, but the maximum amount of payment does not exceed 120 yuan; the outpatient medical expenses paid by the community outpatient coordinated fund for each second-tier and third-tier participant in one The total amount of medical insurance year does not exceed 1000 yuan.

Outpatient treatment for serious illnesses

First-tier insured/second-tier insured/third-tier insured: 60%-90% of outpatient medical expenses are paid by the integrated fund according to the length of continuous participation. First-tier participants and second-tier participants: 95% or 90% of the basic medical expenses incurred in hospitalization and the local supplementary medical expenses above the starting line are paid according to regulations. Participants in the third class: 1. If you can be hospitalized in the settlement hospital of the bounded social welfare center or referred to the prescribed hospital by the settlement hospital, the reimbursement ratio of the basic medical expenses and local supplementary medical expenses incurred above the starting line of hospitalization shall be as follows: first class hospital: 85%, second class hospital: 80%, and third class hospital: 75%. 2. If you can be hospitalized in the prescribed hospital other than the settlement hospital without referral, you will be reimbursed at the ratio of the hospitalization payment standard of the attending hospital. 90% of the hospitalization payment standard of the attending hospital (i.e. the payment standard of Article 1 above).

Legal basis:

Article 32 of Shenzhen Social Medical Insurance Measures (2013): Basic medical insurance participants shall be entitled to medical insurance treatment if they seek medical treatment in accordance with the following provisions:

(1) Participants in the first tier of the basic medical insurance shall seek medical treatment at designated medical institutions in the city.

(2) Participants of the second tier of basic medical insurance shall receive outpatient medical treatment at the selected community health centers, and with the consent of the settlement hospital, they may receive outpatient medical treatment at other designated community health centers under the same settlement hospital as the selected community health centers; and they shall receive medical treatment for inpatient hospitalization and outpatient major illnesses at the designated medical institutions in the city.

(3) Participants of the third class of basic medical insurance can receive outpatient medical treatment at the selected social welfare center, and with the consent of the settlement hospital, they can receive outpatient medical treatment at other designated social welfare centers under the same settlement hospital as the selected social welfare center; they can receive medical treatment for outpatient major illnesses at designated medical institutions in the city; and they can receive medical treatment for inpatient hospitalization at the settlement hospital of the selected social welfare center.

(4) Other cases of medical treatment in accordance with the provisions of these Measures.

Article 33:

Participants in the second and third grades of basic medical insurance shall select a social welfare center in the city as the designated medical institution for outpatient medical treatment. If there is an employer, he shall be selected by his employer; if there is no employer, he shall be selected by himself.

Participants under the age of 14 in the second tier of basic medical insurance can choose a community health center or a hospital of the second tier or lower in the city as the designated medical institution for outpatient treatment.

Participants can change the selected community health center or other designated medical institution, and will be able to seek outpatient medical treatment at the changed community health center or designated medical institution from the month following the effective date of the change.

Article 34:

Referrals for outpatient medical treatment for participants in the second tier of basic medical insurance and for outpatient and inpatient medical treatment for participants in the third tier of basic medical insurance shall be made with the consent of the hospital where the original billing is made. The referral should be referred to a level by level or to a medical institution with specialized expertise at the same level in the city, and the referring hospital should issue a referral certificate to the hospital receiving the referral.