1, the balance of personal account over the years exceeds 6000 yuan;
2。 The total amount of expenses applied for payment is more than 2,000 yuan;
3。 After payment, the balance of personal account funds over the years shall be deposited at least 3000 yuan.
The money in the medical insurance account belongs to individuals. However, the money in the medical insurance pooling fund belongs to every medical insurance applicant. Its purpose is to help each other through social groups in a certain area, share the risk of disease, and solve the medical expenses of employees when they are seriously ill. If the balance of your medical insurance card is insufficient, it must be reimbursed with the money from the overall fund.
Medical insurance cards are used in designated medical institutions,
1。 Designated medical institutions should report the expense list, hospitalization list and related materials of patients discharged from hospital last month to the medical insurance agency before 10 every month, which will be used as the basis for monthly pre-allocation and year-end final accounts after examination;
2。 The medical insurance agency pre-allocated the hospitalization and outpatient co-ordination expenses for special diseases last month;
3。 Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately.
4。 Emergency settlement procedure: the medical expenses incurred by the insured in emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall go through the reimbursement procedures according to the provisions with the hospital emergency medical records, inspections, laboratory tests, invoices and detailed list of medical expenses.
I hope the above content can help you. If in doubt, please consult a professional lawyer.
Legal basis:
Opinions on expanding the scope of payment of surplus funds in personal accounts of medical insurance
Close relatives include spouses, parents, children, brothers and sisters, grandparents, grandchildren and grandchildren. Expenses that can be paid for close relatives:
First, the insured's close relatives to participate in the basic medical insurance for urban and rural residents, the use of rabies vaccine, all kinds of pneumococci, influenza vaccine costs. For example, if a child is vaccinated with flu vaccine, if there is a balance in the medical insurance account of the child's parents or grandparents, the money can be used to pay. However, the form of payment is not a direct credit card, but you need to pay in advance yourself, and then apply to the medical insurance agency in the insured area with relevant certification materials.
Two, the close relatives of the insured meet the basic medical insurance payment scope, and the medical expenses borne by the individual after compensation by the basic medical insurance.