Provisions on reimbursement for purchasing medical insurance cards

Details of medical insurance card reimbursement regulations are as follows:

1. The medical insurance card can only be reimbursed at designated medical institutions. Designated medical institutions should report the expense list, hospitalization list and related materials of patients discharged from hospital 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;

2, medical insurance agencies monthly pre-allocated last month's hospitalization and outpatient special disease co-ordination fees;

3. The insured who is identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security department for medical treatment and purchase medicines, and the medical expenses incurred shall be directly recorded and settled immediately.

4. Emergency settlement procedure: the medical expenses incurred by the insured in emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall go through the reimbursement procedures according to the regulations with emergency medical records, inspection, laboratory sheets, invoices and detailed list of medical expenses.

How many days after medical insurance payment, as follows:

1, for those who participate in basic medical insurance for the first time, the basic medical insurance benefits of the insured who pay the basic medical insurance premium to the local tax department will start from the month when the local tax department collects the medical insurance premium 1, and enjoy the medical insurance benefits according to the relevant provisions of the basic medical insurance;

2. For those who continue the basic medical insurance relationship, if the insured person is employed by a new employer and goes through the renewal procedures within the next month after going through the downsizing procedures with the employer, or continues the basic medical insurance relationship as an individual in the next month and pays the basic medical insurance premium from the month of renewal to the local tax authorities, the basic medical insurance benefits will not be interrupted; If the payment is interrupted, the basic medical insurance benefits will take effect on the month 1 day when the local tax department collects the basic medical insurance premium of the insured;

3. The employer shall be responsible for the medical expenses incurred by the insured from the date of employment by the employer to the effective date of the basic medical insurance payment. The employer shall be responsible for the medical expenses incurred by the insured before the supplementary payment takes effect.

To sum up, different medical insurance reimbursement regulations apply to medical insurance reimbursement, drug purchase, outpatient service and hospitalization. When purchasing medicine, the cardholder goes to the designated medical insurance institution to purchase medicine, and the expenses are paid in the personal account; Go to the outpatient clinic, keep the original diagnosis certificate, medical record, report and expense receipt, and submit them to the local social security agency for reimbursement; Save a certain amount of money when you are in hospital, and settle it according to the proportion of medical insurance reimbursement when you leave hospital.

Legal basis:

Article 27 of People's Republic of China (PRC) Social Insurance Law

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Article 28

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.