12333, as the national public service telephone of human resources and social security system, mainly provides public services such as policy consultation, information inquiry, service guide, complaints and reports in the fields of employment, social insurance, personnel, talent, wage and income distribution, labor relations, etc.
The number of medical insurance centers varies in different regions. Therefore, users need to call the local medical insurance service management center according to their current city and region. In addition, because the medical insurance policy has obvious regionality, it is best to call the city accurately.
: What is the reimbursement rate for medical insurance?
1. outpatient and emergency medical expenses: the medical expenses of employees in the current year (1October1~ February 65438+3 1) that meet the requirements of basic medical insurance exceeded 2,000 yuan.
2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.
3. The insured shall properly keep the outpatient medical documents (including receipts and prescriptions below a large amount) in the designated hospitals as medical expense reimbursement vouchers.
4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.
5. Hospitalization. After paying medical insurance for 20 years, you can enjoy medical insurance reimbursement after retirement.
Precautions:
Pay attention to the age limit: the age of the insured has a certain relationship with the occurrence of disease risk, so the insurer has an age limit for those who participate in medical insurance. Different insurance companies have different regulations on the minimum insurance age, generally ranging from 90 days after birth to 16 years old, while the maximum insurance age limit is roughly the same, generally not exceeding 65 years old.
Pay attention to the scope of insurance liability: insurance liability is the risk insured by the insurance company and the economic compensation liability that should be borne. In hospitalization medical insurance, not all hospitalization risk insurance companies will cover it. At the same time, there are some differences in the insurance liability of insurance companies. For example, there are a large number of the insured's critical illness insurance in the market, which only covers the diseases listed in the insurance clauses, and it is the first time that the patient has been diagnosed after insurance, such as asthma, diabetes, tuberculosis, etc., and this kind of insurance is not covered. The insurance company shall not be liable for the liability that is not covered by the insurance.