How many years can Shaanxi medical insurance enjoy for life?

How many years do I have to pay for medical insurance to enjoy it for life?

1. The policy stipulates that the payment period for men shall not be less than 25 years and that for women shall not be less than 20 years.

2. Medical insurance requirements: the insured is 60 years old for men and 55 years old for women, with the payment period of not less than 25 years for men and not less than 20 years for women. The actual payment period of the basic medical insurance premium must be not less than 15 years, and the insured can enjoy medical insurance benefits after retirement. If the minimum age requirement is not met before retirement, the medical expenses of the actual payment period can be supplemented at one time.

3. If the social security has only been paid for 15 years, and the medical insurance has not been paid enough, you can only receive a pension after retirement and cannot reimburse the doctor.

Second, what are the characteristics of medical insurance?

With the characteristics of "low level and wide coverage", the payment is based on the cost that most units and individuals can bear at a low level, covering all units and employees in cities and towns, and employees of different units can enjoy the rights of basic medical insurance. The insured can enjoy it for life after completing the payment period. Secondly, the basic medical insurance has the characteristics of "the burden of both parties and the combination of unified accounts"; Based on the principle of "balance of payments".

superiority

Enjoy treatment according to uniform standards. The same access conditions, the same fees, the same treatment, there is no difference between high and low. The outpatient expenses of employees can be deducted from their personal accounts and paid by employees after deduction. The hospitalization expenses of employees shall be reimbursed in proportion: 1 1,000 yuan, and 86% of the expenses shall be reimbursed by tertiary hospitals; 65,438+0,000 to 20,000 yuan, and 88% of the expenses are reimbursed by tertiary hospitals; 20,000 to 40,000 yuan, and 92% of the expenses are reimbursed by tertiary hospitals. If employees have not been sick for several years in a row, personal account funds can be accumulated.

disadvantage?

There is a basic deductible for each hospitalization, namely, the first-level hospital 500 yuan, the second-level hospital 750 yuan, and the third-level hospital 1000 yuan. These expenses need to be borne by employees themselves. Class A drugs and Class B drugs are reimbursed in proportion, and imported drugs are not reimbursed. If the amount exceeds 40 thousand, you have to pay for it yourself

3. What are the medical insurance settlement processes?

(1) Settlement procedures for inpatient and outpatient treatment of special diseases

Designated medical institutions shall submit the expense list, hospitalization list and related materials of discharged patients last month to the medical insurance agency before 10 every month, which will be used as the basis for monthly pre-allocation and year-end final accounts after examination. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month.

Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately.

(2) Emergency settlement procedures

The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions and medical institutions in different places in this city shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall handle the reimbursement procedures according to the provisions with the emergency hospitalization medical records, inspection, laboratory test sheets, invoices and detailed list of medical expenses.

(three) resettlement procedures for resettlement personnel in different places

1. The designated medical institution designated as 1-2 by the unit where employees are resettled in different places shall be reported to the medical insurance agency for the record.

2. The medical expenses incurred by the off-site staff in the outpatient department of the designated medical institution where the disease occurs at the place of residence shall be paid in advance by themselves or their units. After the treatment, the unit shall settle the diagnosis and medical records, effective expense bills, compound prescriptions and hospitalization expense lists of the insured. Go to the social medical insurance agency on the specified date.

(4) Referral and settlement.

1. If the insured person is transferred to other medical institutions for diagnosis and treatment due to the conditions of designated medical institutions or specialized diseases, the approval form for referral and transfer shall be filled in. The reason for referral and transfer is put forward by the attending physician, the director of the department puts forward the opinion of referral and transfer, the medical institution medical insurance office reviews it, the dean in charge signs it, and it can be transferred only after being reported to the municipal medical insurance center for examination and approval.

2. In principle, referrals should be made outside the city, inside the province and outside the province. The city's referral regulations are carried out between designated medical institutions. The referral outside the city is proposed by the designated medical institutions above Grade III in this Municipality.

3. The medical expenses incurred after the insured person is referred to another hospital shall be paid by the individual or unit in cash. After the medical treatment, the insured person or his agent will submit the referral approval form, medical record certificate, prescription and valid documents to the medical insurance agency for reimbursement of hospitalization expenses that fall within the scope of the overall fund payment.

Legal basis:

People's Republic of China (PRC) Social Insurance Law (revised on 20 18)

Sixteenth individuals who participate in the basic old-age insurance will receive the basic old-age pension on a monthly basis if they have paid for fifteen years when they reach the statutory retirement age.

Individuals who participate in the basic old-age insurance and pay less than fifteen years when they reach the statutory retirement age can pay for fifteen years and receive the basic pension on a monthly basis; Can also be transferred to the new rural social endowment insurance or urban residents' social endowment insurance, enjoy the corresponding pension insurance benefits in accordance with the provisions of the State Council.