Employee medical insurance where you can query

Where can I inquire about employees' medical insurance?

1. Call 12333 to inquire by phone;

2. Log on to the human resources and social security network of the city where I live to make an online inquiry;

3. Bring the original personal identification and social security card to the window of the local social security agency to make an inquiry;

4. Employing units and individuals have the right to inquire about payment records and to request social insurance agencies to provide social insurance counseling and other related services.

The rules for using the employee health insurance:

1. Eligibility: the employee must be employed or have a fixed work unit, and both the unit and the employee pay health insurance premiums according to the prescribed ratio;

2. Contribution base: the employee's salary income is usually used as the contribution base, and health insurance premiums are paid according to a certain ratio;

3. Reimbursement scope: including outpatient costs, hospitalization costs, drug costs, etc., but the specific reimbursement rate and scope will vary according to regional policies;

4. Designated medical institutions: when using the health insurance, the employee needs to seek medical treatment at designated medical institutions designated by the government, in order to enjoy the health insurance treatment;

5. Individual account: there is usually an individual account in the employee's health insurance for the purpose of storing the individual's contribution, which can be used to pay for the General medical expenses;

6. Referral system: in some areas, a referral system is implemented, i.e., when an employee needs to be hospitalized, he or she needs to go to a primary healthcare institution first, and then be referred to a large hospital after diagnosis;

7. Medical treatment in a different place: for employees who need to seek medical treatment in a different place, they need to apply for medical treatment in a different place in accordance with the stipulated procedures, so as to enjoy the healthcare insurance treatment in the other place;

8、Annual settlement: Employee health insurance is usually settled on an annual basis, and expenses beyond the scope of payment from the individual account can be reimbursed at the time of annual settlement.

In summary, employees can inquire about employee health insurance by calling 12333, logging on to the human resources and social security network, bringing proof of identity and social security card to the window of the social security agency, as well as requesting the social insurance agency to provide relevant services.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 4

Employers and individuals in the territory of the People's Republic of China shall pay social insurance premiums in accordance with the law, and they shall have the right to inquire about the records of premium payment and individual rights and interests, and to request social insurance agencies to provide relevant services, such as social insurance consultation. Individuals enjoy social insurance benefits in accordance with the law, and have the right to supervise the payment of contributions for them by their own units.