Can medical insurance be reimbursed after social security is stopped?

Social security stopped and medical insurance could not be reimbursed.

Medical insurance will not stop immediately, but it will no longer enjoy medical insurance benefits from next month. But it doesn't mean that the medical insurance card can't be used. Although the medical insurance has been suspended, the money in the personal account of the medical insurance card can still be used, which can only be used to buy medicine and see a doctor at the outpatient clinic. If you are hospitalized, you can't enjoy medical insurance reimbursement, and you have to pay for it at your own expense.

Medical insurance has the following provisions:

1. If the insured fails to pay the medical insurance premium in full and on time as required, he will stop enjoying the medical insurance benefits from the month when he never paid it in full and on time. If the payment is continued after the interruption, it must be based on the average salary of local employees in the previous year at the time of payment, and all the arrears during the interruption must be filled. Overdue time is included in the continuous payment time, but you can't enjoy the treatment of pooling funds during the overdue period;

2, the insured to suspend the enjoyment of medical insurance benefits within 60 days (including 60 days) to pay medical insurance premiums, from the next month to enjoy the benefits of pooling funds to pay;

3. If the medical insurance benefits are suspended for more than 60 days to 180 days (including 180 days) to pay back the medical insurance, the benefits paid by the overall fund can only be enjoyed three months after the payment month;

4. If the medical insurance benefits are suspended for more than 180 days and the medical insurance premiums are paid, the benefits paid by the overall fund can only be enjoyed after 6 months from the payment month;

5. If the payment is not made after the interruption, it will be regarded as re-participation in medical insurance, and the payment time before the interruption will not be included in the continuous payment time.

The method of restoring medical insurance after social security payment is as follows:

1. If the payment is continued after the interruption, it must be based on the average salary of local employees in the previous year at the time of payment, and all the arrears during the interruption period must be filled. Overdue time is included in the continuous payment time, but you can't enjoy the treatment of pooling funds during the overdue period;

2, the insured to suspend the enjoyment of medical insurance benefits within 60 days (including 60 days) to pay medical insurance premiums, from the next month to enjoy the benefits of pooling funds to pay;

3. If the medical insurance benefits are suspended for more than 60 days to 180 days (including 180 days) to pay back the medical insurance, the benefits paid by the overall fund can only be enjoyed three months after the payment month;

4. If the medical insurance benefits are suspended for more than 180 days and the medical insurance premium is paid back, it will be calculated from the month of payment and enjoy the treatment paid by the overall fund after 6 months. If the payment is not made after the interruption, it will be regarded as re-participating in medical insurance, and the payment time before the interruption will not be included in the continuous payment time.

In summary, social security has stopped, and medical insurance can no longer be reimbursed. Payment of medical insurance benefits shall be suspended, and medical insurance benefits shall be suspended from the month following the date of suspension of payment.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.