How to open a personal medical insurance certificate?

1. How to format the medical insurance certificate?

This is to certify that the employee of XX Company, gender XX, age XX, applied for medical insurance in our company in X years, and the payment was normal and uninterrupted.

Second, the scope of reimbursement of medical insurance for urban residents

1, outpatient reimbursement

There is no deductible line for general outpatient service, and all insured residents enjoy the treatment of general outpatient service. Within a medical insurance year, there is no deductible for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund payment are reimbursed at the rate of 60%. The annual maximum personal payment limit of co-ordination fund is 400 yuan.

2. Proportion of hospitalization reimbursement

The longer the continuous insurance period, the greater the reimbursement ratio. After the insured residents continue to pay fees, the proportion of hospitalization reimbursement of medical insurance fund will increase by 5 percentage points every 5 years, and the accumulated amount will not exceed 10 percentage point. If you continue to participate in insurance 10 years from 2007, the reimbursement rates of hospitalization in tertiary, secondary and primary hospitals will reach 70%, 80% and 90% respectively.

3. Secondary reimbursement ratio

The medical expenses incurred by insured residents in hospitalization for many times every year, after being paid by basic medical insurance and "second reimbursement", the cumulative burden of hospitalization medical expenses (including compliance and reasonable self-funded part) exceeds 2. For the part exceeding 50,000 yuan, the serious illness insurance fund will give "reimbursement again" for the part exceeding 55%, and the annual maximum personal payment limit of the serious illness insurance fund is 250,000 yuan.

Third, the proportion of urban residents' medical insurance reimbursement

Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.

Students, children

In a settlement year, medical expenses less than 6,543,800 yuan+0.8 million yuan that meet the scope of reimbursement occurred. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

At least 70 years old and above.

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

Other urban residents

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold for tertiary hospitals is 659 yuan, the reimbursement rate is 50%, and the upper limit is 2,000 yuan. The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

Legal objectivity:

People's Republic of China (PRC) social insurance law

Article 23

Employees should participate in the basic medical insurance for employees, and employers and employees should jointly pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

People's Republic of China (PRC) social insurance law

Article 24

The state establishes and improves the new rural cooperative medical system.

Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.