I have medical insurance. Why do you show me at my own expense?

After applying for medical treatment in different places, the insured in this Municipality will go to the designated medical institutions for medical treatment with a social security card (or medical insurance in electronic certificate), and the medical expenses incurred can be directly settled in principle.

If you still prompt "at your own expense" when seeing a doctor, there may be the following situations:

1. The medical expenses did not reach the reimbursement deductible line of this accounting year (from 65438+ 10/to 65438+February 3 1).

Two, the unit owes money or the individual fails to pay the medical insurance premium on time, which leads to the insured person can not enjoy the medical insurance reimbursement treatment normally.

Three, the medical expenses incurred in accordance with the relevant provisions of this medical treatment are not within the scope of the basic medical insurance catalogue and need to be paid by individuals.

Four, after going through the insurance formalities, the medical insurance payment has not been completed (the medical insurance fee for the next month was deducted successfully by the tax department, and the medical expenses can be settled in real time by card (code)).

For example, in April, the company went through the formalities of increasing employees for the insured, in May, the tax authorities collected the medical insurance expenses for April, and in June, 1, the insured can settle the accounts in real time with one card. (If the medical expenses cannot be settled in real time after the payment is successful, you can apply for manual reimbursement to the medical insurance agency in the insured place through the unit (social security office))

V. Construction of medical insurance settlement system.

For example, the hospital does not have the function of real-time settlement of outpatient service or hospitalization in different places; The hospital medical insurance system temporarily failed. (In this case, if the medical expenses cannot be fully settled in real time, the insured can apply for manual reimbursement to the medical insurance agency in the insured place through the unit (social security office)).

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

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.