Can the family share the medical insurance card, and can the family share the medical insurance card

Your family's health insurance card.

Try not to share. Usually, the money in the medical insurance card account can be used by the family, such as helping to buy medicines, paying medical bills, etc., but the personal treatment corresponding to the medical insurance card, such as seeing a chronic disease.

Hospitalization, critical illness and other functions cannot be shared with others.

The first executive meeting held a few days ago.

It is determined that the state will introduce measures to "establish and improve the outpatient mutual aid guarantee mechanism of basic medical insurance for employees", broaden the scope of use of funds in personal accounts, and allow family members to help each other. "Employee medical insurance family mutual aid" refers to the personal account of employee medical insurance.

The funds can be used by family members to help each other, for example, to pay for them at designated medical institutions.

Medical treatment, as well as the purchase of drugs, medical devices and medical consumables at designated retail pharmacies, shall be borne by the individual. The medical insurance card corresponds to the treatment of each insured, and the treatment qualifications of inpatient and outpatient severe and chronic diseases cannot be "mutually aided".

Broadening the scope of use of funds in employees' personal medical insurance accounts and allowing family members to help each other does not mean that "one person is insured and the whole family enjoys".

Medical insurance card or national medical insurance electronic voucher.

It contains the name, gender, and ID card of each of our insured persons.

No., **, social security number and other information, the implementation of "one person, one card", and the same ID card, only the real name of the person to use, must be "special card exclusive".

At the same time, it is "fraud and deception" to seek medical treatment in the name of another person's medical insurance card, and the insured person should use his or her medical insurance card (social security card) or medical insurance electronic voucher to seek medical treatment and purchase drugs in his real name, and properly keep his or her medical insurance card (social security card) to prevent others from using it in a fraudulent name. Lending one's medical insurance card to another person for medical treatment or using another person's medical insurance card to seek medical treatment in a fraudulent name is an act of fraud and insurance fraud.

According to the relevant provisions of the "Regulations on the Supervision and Administration of the Use of Medical Insurance", which will be implemented on May 1, if someone else's medical insurance card (social security card) or medical insurance electronic voucher is used to seek medical treatment or purchase drugs in a fraudulent name, resulting in the loss of medical insurance, the person involved in the case will be suspended from real-time settlement of medical expenses; It is also subject to a fine (2 to 5 times the amount of fraud) imposed by the medical insurance administrative department; If a crime is constituted, criminal responsibility will be pursued in accordance with law.

It can be used, but there are limitations.

On May 25, 2012, the Taizhou Municipal Human Resources and Social Security Bureau issued the "Opinions on Expanding the Scope of Payment of Balance Funds in Medical Insurance Personal Accounts", which mentioned that some expenses incurred by close relatives of insured persons are allowed to be paid with the balance funds of personal accounts over the years.

However, the insured person must meet three conditions at the same time when he or she uses the money accumulated over the years of the medical insurance card to pay for the expenses incurred by close relatives:

1. The balance of funds in the personal account over the years exceeds 6,000 yuan;

2. The total amount of fees to be paid is more than 2,000 yuan;

3. After payment, the balance of funds in the personal account over the years shall not be less than 3,000 yuan.

If the insured person pays the expenses incurred by his or her close relatives from the balance of his personal account over the years, he or she shall apply to the medical insurance agency in the place of insurance with relevant supporting materials, such as household registration booklet, marriage certificate, etc., medical insurance card, original vouchers of hospital charges, lists and medical records.

The health insurance card can be shared by the family, but try not to share it.

The medical insurance card of the immediate family can be shared, but it can only be used to buy medicine and see outpatient clinics at designated medical institutions, and cannot be used for medical expense reimbursement. For example, parents can use their children's medical insurance cards to buy drugs at designated pharmacies, but if they use their children's medical insurance cards to reimburse hospitalization medical expenses, then it is a violation and insurance fraud, and they will be subject to certain penalties, including fines and suspension of online settlement of medical expenses. In addition, repeated enjoyment of medical insurance benefits, taking advantage of the opportunity of medical insurance benefits to resell drugs, taking advantage of the opportunity of medical insurance benefits to accept cash or in-kind returns, or obtaining other illegal benefits are all insurance fraud.

Social medical insurance is a social insurance system established by the state and society in accordance with certain laws and regulations to provide basic medical needs for workers within the scope of insurance. Social medical insurance consists of three levels: basic medical insurance, large-amount medical assistance, enterprise supplementary medical insurance and individual supplementary medical insurance.

Legal basis

Regulations of the People's Republic of China on Basic Medical Insurance for Urban Employees

Article 28 The personal account is used to pay for medical expenses outside the scope of the overall payment; If the personal account is insufficient to pay, the person shall be responsible for it.

Article 29 The medical expenses for hospitalization for serious illness** shall be paid in accordance with the following methods:

1) In principle, the minimum payment standard shall be controlled at 9-11 of the average annual social wage of employees in cities, counties and autonomous counties in the previous year

2) In principle, the maximum payment limit shall be controlled at 3-5 times the average annual social wage of employees in cities, counties and autonomous counties in the previous year.

3) Medical expenses above the minimum payment standard and below the maximum payment limit shall be mainly paid by the overall plan, and a certain proportion shall be borne by the individual. Appropriate consideration is given to the proportion of medical expenses borne by retirees.

Yes, on the eve of the Asian Games, Guangzhou City issued a series of medical insurance policies to benefit the people. Since November, the scope of use of the funds in the personal account of the medical insurance card has been expanded, from the previous limited to the insured to see a doctor and purchase drugs by themselves, to the whole family to use. Since the implementation of the new policy, the reporter interviewed the Guangzhou Municipal Human Resources and Social Security Bureau of the Medical Insurance Department, and learned that the new policy has brought convenience to the general public, parents can use the medical insurance card to pay medical premiums for their children, children can help the elderly at home pay for the self-paid part of outpatient chronic diseases, and flexible employment personnel can use the funds on the medical insurance account of their families, but the relevant departments also reminded that if there are insured people who take this good opportunity to maliciously cash out, it is never allowed, once found, or the card will be deducted.

The reporter visited various hospitals and found that since the implementation of the policy for half a month, about 10% of the people who share the medical insurance card with their family members. In the past, according to the policy, the funds in the personal account of the employee's medical insurance were limited to the personal special funds of the insured. This month, the new policy measures were implemented, and the funds in the personal account of the medical insurance card can be used not only for themselves, but also for relatives.

In accordance with the newly promulgated "Notice on Adjusting the Relevant Treatment Standards of Guangzhou Basic Medical Insurance and the Payment Scope of Personal Medical Account", the insured can use personal account funds to pay for himself and his relatives, including the payment of social medical insurance premiums, the medical expenses incurred in the designated medical institutions of the city's medical insurance, the cost of vaccination and physical examination in the designated medical institutions of the city's medical insurance, and the purchase of drugs and medical supplies in the city's medical insurance designated retail pharmacies. If you are not clear, open the following page.

Only when purchasing drugs can you buy drugs by swiping your card at designated pharmacies. Hospitalization is not for anyone else. Medical insurance is for the exclusive use of special personnel.

Legal analysis: can not be directly shared, if you want to realize the sharing of the medical insurance personal account and the family, that is, the family members of the mutual aid, first need the user to set up a medical insurance mutual aid account, and then transfer the money from the personal account of the medical insurance card to the medical insurance mutual aid account, and then bind the medical insurance mutual aid account to the medical insurance personal account of other members of the family, so that the family will still directly swipe their own medical insurance card account to pay when buying medicine, and the funds in the medical insurance provident fund account will be used if the funds in the personal medical insurance account are insufficient.

Legal basis: "Regulations on the Supervision and Administration of the Use of Medical Insurance" Article 41 If an individual has any of the following circumstances, the medical security administrative department shall order corrections; If the loss of medical security is caused, it shall be ordered to be returned; If it is an insured person, the online settlement of medical expenses shall be suspended for 3 months to 12 months: (1) hand over the medical insurance certificate to others for fraudulent use; (2) Repeated enjoyment of medical security benefits; (3) Taking advantage of the opportunity to enjoy medical security benefits to resell drugs, accept the return of cash or goods, or obtain other illegal benefits.

An individual commits one of the acts provided for in the preceding paragraph for the purpose of fraudulently obtaining medical security**, causing a loss of medical security**; or using another person's medical security certificate to seek medical treatment or purchase medicine in a false name; or through forgery, alteration, concealment, alteration, destruction of medical documents, medical certificates, accounting vouchers, electronic information and other relevant materials or fictitious medical service items, etc., to defraud medical security expenditures, in addition to the provisions of the preceding paragraph, shall also be fined by the medical security administrative department of not less than 2 times but not more than 5 times the amount of fraud.

Family members' health insurance cards cannot be shared. "Allowing family members to help each other" does not mean that "the medical insurance card can be used by the whole family", broadening the scope of use of funds in the personal account of employees' medical insurance, and allowing family members to help each other, does not mean that "one person participates in the insurance, the whole family enjoys". Fanchai national principle of "I participate in insurance, I enjoy treatment", only by participating in medical insurance according to the regulations, can you get reimbursement for medical expenses through medical insurance when you are sick.

The process of applying for a medical insurance card is as follows:

1. The insured person should bring his or her valid documents (ID card, household registration booklet, etc.) to the neighboring district and county medical insurance center to apply for processing, and the district and county medical insurance center will complete the application on the spot;

2. The insured can also apply for handling on behalf of the medical insurance service point of the adjacent street (town), and the service point will be completed within 3 working days. The insured person shall go to the service point within the specified time to collect the medical insurance card handled on behalf of the insured;

3. The insured can entrust others to handle it on his behalf. The entrusted person shall bring the valid documents of himself and the insured person when handling the application;

4. When the employer handles it in a centralized manner, it can go to the medical insurance center of Yan County, the district to which it belongs with the letter of introduction of the unit and the valid certificate of the person in charge, and then the employer will issue the medical insurance card to the insured.

Legal basisArticle 17 of the Regulations on the Supervision and Administration of the Use of Medical Security**.

The insured person shall take his or her own medical security certificate to seek medical treatment and purchase medicines, and take the initiative to present it for inspection. The insured person has the right to request the designated medical institution to truthfully issue the expense documents and relevant information. Insured persons shall properly keep their own medical security certificates to prevent others from using them in their names.

If it is necessary to entrust another person to purchase drugs on behalf of the client due to special reasons, the identity certificates of the principal and the trustee shall be provided. Insured persons shall enjoy medical security benefits in accordance with the provisions and shall not enjoy them repeatedly. The insured person has the right to request the medical security agency to provide medical security consulting services and make suggestions for improving the use of medical insurance**.

Legal Analysis: Yes. Family members can use it at the designated hospital on the medical insurance card, but they can only use the personal portion of the account amount.

Legal basis: "Guiding Opinions of the General Office on Establishing and Improving the Outpatient Mutual Aid Security Mechanism of Basic Medical Insurance for Employees" clarifies the scope of use of the medical insurance card, and clearly stipulates that the medical expenses borne by the insured and their spouses, parents, and children in designated medical institutions, and the drugs, medical devices, and medical consumables purchased by the designated pharmacies of the medical insurance can be reimbursed with the personal account of the medical insurance card of the insured person. That is to say, the insured person, his parents, spouse, and children can use the personal account of the insured person's medical insurance card, so the medical insurance card can be used by the whole family.

Legal analysis: can not be directly shared, if you want to realize the sharing of the medical insurance personal account and the family, that is, the family members of the mutual aid, first need the user to set up a medical insurance mutual aid account, and then transfer the money from the personal account of the medical insurance card to the medical insurance mutual aid account, and then bind the medical insurance mutual aid account to the medical insurance personal account of other members of the family, so that the family will still directly swipe their own medical insurance card account to pay when buying medicine, and the funds in the medical insurance provident fund account will be used if the funds in the personal medical insurance account are insufficient.

Legal basis: "Regulations on the Supervision and Administration of the Use of Medical Insurance" Article 41 If an individual has any of the following circumstances, the medical security administrative department shall order corrections; If the loss of medical security is caused, it shall be ordered to be returned; If it is an insured person, the online settlement of medical expenses shall be suspended for 3 months to 12 months: (1) hand over the medical insurance certificate to others for fraudulent use; (2) Repeated enjoyment of medical security benefits; (3) Taking advantage of the opportunity to enjoy medical security benefits to resell drugs, accept the return of cash or goods, or obtain other illegal benefits.

An individual commits one of the acts provided for in the preceding paragraph for the purpose of fraudulently obtaining medical security**, causing a loss of medical security**; or using another person's medical security certificate to seek medical treatment or purchase medicine in a false name; or through forgery, alteration, concealment, alteration, destruction of medical documents, medical certificates, accounting vouchers, electronic information and other relevant materials or fictitious medical service items, etc., to defraud medical security expenditures, in addition to the provisions of the preceding paragraph, shall also be fined by the medical security administrative department of not less than 2 times but not more than 5 times the amount of fraud.