1. Increase in the proportion of outpatient reimbursement: the proportion of medical insurance reimbursement for first-and second-class employees has increased from 60% of the original unified account combined with outpatient reimbursement to 75%, and the outpatient medical expenses incurred by designated medical institutions at the grassroots level have been adjusted from the original personal account payment to the general outpatient reimbursement;
2. Increase the reimbursement limit: in 2023, the reimbursement limit for medical insurance will be10.7 million yuan for outpatient service, and 510.0 million yuan for hospitalization for Class I insured personnel; The second insured outpatient 1500 yuan, hospitalized for 4,500 yuan;
3. Expand the scope of reimbursement: Shenzhen 16 kinds of common diseases and frequently-occurring diseases (including mental illness) will be included in the scope of outpatient special disease protection, and medical insurance cards or medical insurance electronic certificate will be directly swiped at designated medical institutions in the city according to the inspection and treatment items specified in the corresponding medical service standards;
4. Improve the reimbursement standard for maternity medical expenses: employees who participate in Shenzhen social security will be reimbursed according to in-depth standards, with a maximum of 2,500 yuan.
Medical insurance reimbursement conditions:
1, the insured must meet the requirements of the national medical insurance, that is, pay the corresponding medical insurance fees under the national medical insurance system;
2, medical expenses must comply with the provisions of the national medical insurance medical service directory, including drugs, treatment items, inspection items, surgical items, etc. ;
3. Medical expenses must be consumed in medical institutions designated by medical insurance, that is to say, the insured can only enjoy medical insurance reimbursement services in medical institutions designated by medical insurance;
4. Medical expenses must be submitted for medical insurance reimbursement within the specified time. It is generally required to submit an application within a certain period of time after seeing a doctor;
5. The balance of the insured person's personal account must be sufficient, otherwise the medical insurance reimbursement service cannot be enjoyed.
To sum up, the process of reissuing medical insurance cards in different regions and different types of medical insurance may be different, and the specific process needs to be determined according to local actual conditions and policies.
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.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.