How to reimburse medical expenses with social security card?

Hello: When you enter or leave the hospital, you must go through the registration formalities at the medical insurance management window of each designated medical institution with your medical insurance IC card.

After the insured is hospitalized, the deductible line of the overall fund is divided into three grades: tertiary hospital 1000 yuan, secondary hospital 600 yuan, and primary hospital 400 yuan. In a basic medical insurance settlement year, the medical expenses for multiple hospitalizations are calculated cumulatively. If the insured person needs to be referred to the hospital due to illness, the deputy chief physician or director of the designated medical institution (level 3 or above) will put forward the opinions of the referral (hospital) after diagnosis, and the unit to which he belongs will fill in the application form and go through the referral (hospital) formalities with the approval of the medical insurance management department of the designated medical institution. When discharged from a designated medical institution, the designated medical institution calculates the reimbursement amount and the amount that the individual should pay in accordance with relevant policies. The amount of reimbursement shall be settled by designated medical institutions and urban social insurance agencies, and the amount payable by individuals shall be settled by designated medical institutions and insured persons. When you go to a designated hospital for medical treatment, you can show your medical insurance card to prove your insured identity and registration. Individuals do not need to pay first and then reimburse, and medical insurance and hospitals can directly settle the part of medical insurance reimbursement.

Continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on. In fact, social security can be used for reimbursement after seeing a doctor, but it is also very important common sense to abide by the regulations when reimbursing expenses. Medical expenses can only be reduced after reimbursement.

This law is based on Article 2 of the Social Insurance Law of People's Republic of China (PRC).

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 6 The State exercises strict supervision over social insurance funds. The State Council and the people's governments of provinces, autonomous regions and municipalities directly under the Central Government shall establish and improve the supervision and management system of social insurance funds to ensure the safe and effective operation of social insurance funds. People's governments at or above the county level shall take measures to encourage and support all sectors of society to participate in the supervision of social insurance funds.