The medical insurance system is one of the important systems of modern society, which cooperates with pension insurance and unemployment insurance to jointly build a social security system. Here are some information about the medical insurance payment process for your reference and Xi.
Medical insurance payment process
1.Renewal: Please pay between October 25 and December 25.
2.Newly insured persons and those who have lost insurance in the current year: Please bring your resident ID card or household registration booklet to the town (street) convenience service center or village (community) convenience service station where your household registration is located from October 25 to December 25 (except statutory holidays) to go through the registration procedures, and then pay the fee at the outlets of the paying bank with valid ID documents, or pay the fee through the bank's mobile app. It should be noted that among the newly insured persons, newborns should be insured and paid within 90 days from the date of birth, unemployed persons from the date of unemployment or expiration of unemployment benefits, retirees from the date of not enjoying the basic medical insurance benefits for employees, and non-local residents from the date of household registration. If it is overdue, there is a 90-day waiting period for treatment from the date of actual payment, and no resident medical insurance treatment will be enjoyed during the waiting period.
3.Persons in difficulty: In line with the requirements of the Civil Affairs, the Disabled Persons' Federation, the Federation of Trade Unions, the Veterans Affairs Bureau and other departments recognized by the subsistence allowance, extremely poor people, children in difficulty, social poverty, 60s streamlined retirement, preferential care, severely disabled insured persons, please bring your ID card or household registration book to the town (street) convenience service center or village (community) convenience service station where the household registration is located to go through the insurance registration and information confirmation procedures, and individuals are exempted from payment.
4.Hong Kong, Macao and Taiwan residents: According to the provisions of No. 20 61 and No. 20 16 of Xi Medical Insurance Service, unemployed Hong Kong, Macao and Taiwan residents who live in Xi and apply for a residence permit for Hong Kong, Macao and Taiwan residents can participate in the basic medical insurance for urban and rural residents in their place of residence, and pay according to the same standard as the local urban and rural residents, and enjoy the same basic medical insurance treatment Go to the comprehensive window of each district of the Municipal Medical Insurance Center to go through the insurance procedures.
5.Current students: During the centralized collection period, the school will handle the insurance participation and payment by the school.
6.Unemployed medical personnel: Insured resident medical insurance personnel need to go through the procedures for suspension of resident medical insurance at the medical insurance handling window on the date of receiving unemployment benefitsThose who have participated in the resident medical insurance in the current year and have been suspended due to the receipt of unemployment benefits have continued to enjoy the benefits of the resident medical insurance in the month after the expiration of the unemployment pension period, and need to go to the medical insurance office to go through the procedures for resumption of insurance.
7.Preschool children holding a residence permit in our city: Please bring the residence permit of preschool children, household registration booklet and the proof that at least one parent has participated in the employee medical insurance payment in our city for one year, and go to the town (street) convenience service center or village (community) convenience service station where you live to go through the insurance procedures.
Medical insurance payment channels
1.You can use the WeChat "Social Security Cloud Payment" or "Jiangsu Tax and Social Security Payment" mini program to pay.
2.Payers who have signed a bank debit agreement should ensure that there is sufficient amount in their bank account for automatic debit by 30 November. If there is a change in the bank account (deducted through the bank account bound to the social security card, and the social security card is replaced in the current year), please re-sign the deduction agreement with the bank in time or choose other ways to check and pay the fee by yourself.
3.The insured person who has not signed a deduction agreement with the bank can pay the fee at any outlet of Bank of China, China Construction Bank, Bank of Communications, Postal Savings Bank, Bank of Jiangsu, Wuxi Rural Commercial Bank and other banks with valid identity documents, or can complete the payment on the mobile app of China Construction Bank, Bank of Jiangsu, Wuxi Rural Commercial Bank and other banks.
Medicare reimbursement process
1.After the patient is treated in a private hospital, he or she needs to go to the designated pharmacy to purchase drugs with his ID card, and then go to the hospital's ** window for reimbursement with the prescription and drug receipt
2.When reimbursing, you need to prepare your ID card, social security card, valid documents for the implementation of medical insurance policies, and medical records for each visit
3.When reimbursing, if the reimbursement amount exceeds the upper limit of local medical insurance reimbursement, the patient can apply for a waiver, and part of the fee will be waived after review.
The medical insurance reform caused turmoil, and whether individuals suffered or not
Suppose a retiree in Zhengzhou has a monthly pension of 4,000 yuan. According to the previous standard, they would receive 4,000 45% = 180 yuan, and after the implementation of outpatient mutual aid, the cost of its monthly medical insurance personal account is adjusted to 2% of the per capita pension, according to online data, the per capita pension of Henan workers in 20 years is 3278 yuan, so that the cost of its monthly medical insurance personal account will become 3278 2% = 6556 yuan.
If he goes to a ** hospital for outpatient treatment due to cervical spondylosis, he can be reimbursed for 3,000 yuan. According to the outpatient mutual aid policy, excluding the minimum payment (also known as the threshold fee) of 40 yuan, according to the reimbursement ratio of 55% of the ** hospital, it can be reimbursed (3000-40) yuan 55% = 1628 yuan. Although his personal account was less than about 1,400 yuan, he enjoyed more than 200 yuan of treatment.
According to the policy of Wuhan outpatient mutual aid, if Mr. Li, an in-service employee, has an annual income of 80,000 yuan and suffers from a chronic disease. He sought medical treatment in an outpatient clinic in a secondary hospital, and incurred reimbursable expenses of 4,000 yuan, excluding the starting line of 700 yuan, according to the reimbursement ratio of 60% of the secondary hospital, reimbursable (4,000-700) yuan 60%=1,980 yuan. Although Mr. Li's personal account was less than $1,360 after the outpatient consultation, he enjoyed $620 more.
What is the national health insurance?
There are the following:
The first refers to the basic medical security system established in accordance with the relevant regulations, also known as social basic medical insurance, which is a social security system that is managed by the national medical security department and implemented by the medical security departments at all levels. At present, China's national basic medical insurance system is divided into basic medical insurance for urban workers and basic medical insurance for urban and rural residents.
The second mainly refers to the fact that China's medical insurance system is managed in accordance with the localized model, and is currently in accordance with the prefecture-level administrative units as the overall planning area. The medical insurance with the municipal city as the overall unit is called the municipal medical insuranceThe medical insurance with the provincial unit as the overall planning area is called the provincial medical insurance
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