If the money on the medical insurance card is used up, can I still use the medical insurance to reim

The reimbursement amount of medical insurance diagnosis and treatment expenses is directly deducted from the total amount at the time of discharge settlement, not to the card, and the individual needs to pay the self-pay part after reimbursement.

Taking Zhengzhou City as an example, according to Article 25 of the Measures for Basic Medical Insurance for Employees in Zhengzhou City, it is mainly used to pay for inpatient medical expenses, outpatient medical expenses for prescribed diseases and outpatient medical expenses for major diseases.

The personal account is mainly used to pay for general outpatient medical expenses, drug purchase expenses and inpatient medical expenses, etc., and when the balance of the personal account is insufficient to pay, the excess part shall be borne by the individual. Co-ordination and personal accounts are accounted for separately, and they must not be misappropriated from each other.

Article 29 Hospitalization medical expenses that exceed the minimum payment standard and do not exceed the maximum payment limit shall be paid in accordance with the following proportions

1) For in-service employees who are hospitalized, the overall payment ratios are: 95% for community health service institutions, 95% for first-class medical institutions, 90% for second-class medical institutions, and 88% for third-class medical institutions;

2) For retirees who are hospitalized, the overall payment ratios are: 97% for community health service institutions, 97% for Class I medical institutions, 95% for Class II medical institutions, and 93% for Class III medical institutions.

Co-ordination**The maximum payment limit is $150,000 per year. After the cumulative payment reaches the maximum payment limit in the overall natural year, the excess medical expenses shall be paid by the commercial supplementary medical insurance for employees, and the specific measures shall be implemented in accordance with the current regulations.

You can continue to use it. Under normal circumstances, if you participate in employee medical insurance, but later stop paying due to resignation and other principles, then your medical insurance account will be sealed in the next month after you stop paying premiums, and you will not be able to enjoy medical insurance benefits. This is because medical insurance is different from endowment insurance, medical insurance is pay-as-you-go, use the current money to see the current disease, pay to enjoy the medical insurance treatment, do not pay can not enjoy.

That said, that doesn't mean that the money left on your health insurance card will be wiped out and forfeited. During the period when your account is sealed, the remaining money in the medical insurance card can still be used, which can be used to see a doctor at the designated hospital of the medical insurance and settle with the card until the money in the medical insurance card is used up.

The money in the medical insurance card can be reimbursed when it is used up, and it should be decided according to the actual situation. If there is no balance in the medical insurance card, you need to pay for the doctor. Employee medical insurance is generally divided into individual accounts and pooled accounts, including:

1. The personal account can pay the following expenses: the cost of drug purchase in designated retail pharmacies, outpatient and emergency medical expenses, for the purchase of commercial insurance, accident insurance, etc., the medical expenses below the basic medical insurance co-ordination standard, exceeding the basic medical insurance co-ordination ** payment standard, according to the proportion of personal payable expenses, and the personal account is insufficient to pay the part by the person;

2. The overall account mainly pays the following expenses: medical expenses for hospitalization**, outpatient medical expenses for malignant tumor radiation**, kidney dialysis, and anti-rejection drugs after kidney transplantation, and medical expenses for patients admitted to hospitalization after emergency rescue, and their medical expenses within seven days of observation before hospitalization.

The medical expenses incurred by the insured persons in the agreed medical institutions shall be paid from the basic medical insurance in accordance with the provisions of the basic medical insurance in accordance with the standards of the basic medical insurance drug catalog, diagnosis and treatment items, and medical service facilities. If the insured person really needs emergency treatment and rescue, then he or she can seek medical treatment in a non-agreement medical institution. Since the drugs that must be used in the rescue, then the scope can be appropriately relaxed.

The specific management measures for emergency and rescue medical services for insured persons can generally be formulated by the overall planning area according to the actual local situation.

[Legal basis].

Article 8 of the Detailed Rules for the Implementation of the Social Insurance Law of the People's Republic of China.

The medical expenses incurred by the insured persons in the agreed medical institutions shall be paid from the basic medical insurance in accordance with the provisions of the basic medical insurance in accordance with the standards of the basic medical insurance drug catalog, diagnosis and treatment items, and medical service facilities. If the insured person really needs emergency treatment or rescue, he or she can seek medical treatment in a non-agreed medical institution; The scope of drugs that must be used for rescue purposes may be appropriately relaxed. The specific management measures for medical services for emergency and rescue of insured persons shall be formulated by the overall planning area according to the actual local situation.

Answer: Whether there is money in the social security card and medical insurance personal account is not directly related to whether you can enjoy medical reimbursement for medical treatment. We must first figure out what is a medical insurance personal account, which is for the basic medical insurance to participate in personal records, store personal account funds, and apply to outpatient clinics, pharmacies for personal medical consumption. The basic medical insurance referred to here only includes the basic medical insurance for employees, and does not include the basic medical insurance for urban and rural residents, that is, the new rural cooperative medical system often referred to by the common people.

The money in the personal account of the social security card and medical insurance mainly comes from the return, and the in-service personnel are calculated and issued according to the personal payment base, and the proportion is according to the age of the individual, 30 years old and below, 31 to 45 years old, and 46 years old and above; For retirees, 6% of the monthly pension of the previous year will be returned, and in general, the older the age, the more rebates will be in the medical insurance personal account. How do we reimburse our personal account if we don't have money?

Outpatient reimbursement. The use of the "personal account" money of the social security card does not mean that it is used up completely, and you can continue to enjoy outpatient medical treatment, but a certain threshold fee is required. That is, in a settlement year, after the patient pays a certain amount of expenses, within the specified limit, the outpatient reimbursement will be made in proportion to the outpatient level. For example, in our local area, Xiao Li's medical insurance "runs out", if he is sick and spends 800 yuan to see a doctor in a community clinic, the on-the-job out-of-pocket payment standard is 400 yuan, and the proportion of 80% of the community outpatient clinic is paid, that is, Xiao Li's reimbursement is = (800-400) 80% = 320 yuan.

The above is just an example, outpatient reimbursement is mainly used in township health centers, village (community) health centers, etc., due to the different medical standards in various places, the self-payment standards, the prescribed limits and reimbursement ratios are different, and the specific reimbursement is implemented according to the medical insurance policy of the place where the insurance is insured.

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Question: Look at the outpatient clinic for two days, it is not easy to report.

If the money in the medical insurance card is used up, as long as the medical insurance is not interrupted, then it can still be reimbursed. The so-called money in the medical insurance card is used up, generally refers to the money in the personal account, that is, part of the premiums paid by the unit and the premiums paid by the employees, and the money into the medical insurance card is used up every month, which is mainly used to pay for self-paid expenses, such as ordinary outpatient services, buying medicines, etc., and when reimbursing medical expenses such as inpatient medical expenses and special outpatient services, the medical insurance card co-ordination account is used.

[Legal basis].Article 64 of the Social Insurance Law of the People's Republic of China.

Social insurance** includes basic endowment insurance**, basic medical insurance**, work-related injury insurance**, unemployment insurance** and maternity insurance**. In addition to the basic medical insurance** and maternity insurance** combined accounts and accounting, other social insurance** according to the type of social insurance separately established and accounted for. Social insurance** implements a unified national accounting system.

The special funds for social insurance are used exclusively and shall not be embezzled or misappropriated by any organization or individual. The basic endowment insurance will gradually implement the national overall planning, and the other social insurance will gradually implement the provincial overall planning, and the specific time and steps will be specified by the national level.

Can I withdraw the money from my health insurance card?

The money in the health insurance card is generally not directly withdrawn. If the insured person incurs medical expenses due to illness and hospitalization, he or she can go to the social insurance agency, designated medical institution, or pharmacy to settle directly according to the law, but the money in the medical insurance card cannot be used like cash.

Yes, it is reimbursable. Because the money in the medical card, the balance of the personal account of the medical insurance is mainly used for personal expenses such as buying drugs and outpatient payments, which is different from medical insurance reimbursement.

As long as your medical insurance is paid normally, the proportion of medical insurance reimbursement is fixed, and the reimbursement of medical insurance expenses is directly deducted from the total amount when the hospital is discharged from the hospital, and there is no conflict between the two.

Legal basis: Social Insurance Law》 Article 28 In line with the basic medical insurance drug list, diagnosis and guess code treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance spike and erection **.

Article 29 of the Social Insurance Law of the insured persons shall be paid by the basic medical insurance ** part of the medical expenses, which shall be directly settled by the social insurance agency and the medical institution and the drug business unit.

The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

Article 30 of the Social Insurance Law The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third person does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

Use the funds allocated for medical expenses in the social security card, that is not reimbursement, it will be used up and will be used again, waiting for the next allocation.

The specific reimbursement ratio is stipulated by the local social security bureau, and the reimbursement amount of medical insurance diagnosis and treatment expenses is directly deducted from the total amount at the time of discharge settlement, not to the card, and the individual needs to pay the self-payment part after reimbursement.

Zheng's so-called use of money in the medical insurance card generally refers to the use of money in the personal account (part of the premiums paid by the unit and the premiums paid by the employees, and the money paid into the medical insurance card every month), which is mainly used to pay for self-paid expenses, such as general outpatient services, buying medicines, etc., and when reimbursing medical expenses such as inpatient medical expenses and special outpatient services, the medical insurance card co-ordination account is used.

Even if the money in the personal account is used up, it will only affect the payment of the insured's out-of-pocket expenses, which can only be paid by the insured himself, but it will not affect the reimbursement of the overall account.

Question: I said at Shuguang Hospital today that I can't be reimbursed.

The medical insurance card is divided into a personal account and a co-ordinated account, and when it is used up, it means that the money in the personal account is used up, and the money in the co-ordinated account can also be reimbursed.

Legal analysis: the money in the medical insurance card can be reimbursed when it runs out, and the specific reimbursement ratio is stipulated by the local social security bureau, and the reimbursement amount of medical insurance diagnosis and treatment expenses is directly deducted from the total amount of trillions at the time of discharge settlement, not to the lack of guess card, and the individual needs to pay the self-pay part after reimbursement.

Legal basis: "Social Insurance Law of the People's Republic of China" Article 27 Individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, the cumulative contributions reach the number of years prescribed by the state, they will no longer pay the basic medical insurance premiums after retirement, and enjoy the basic medical insurance benefits in accordance with the provisions of the state; If the number of years prescribed by the state has not been reached, the fee can be paid until the number of years prescribed by the state.