The medical insurance payment process is as follows:
1, the insured shall continue the basic old-age insurance relationship in accordance with the regulations when they are newly employed and pay the fee, which shall be borne by the employer or the insured.
Submit a written application for the transfer of the basic old-age insurance relationship to the medical insurance agency of the newly insured place;
2./kloc-within 0/5 working days, the medical insurance agency in the newly insured place will review the application for transfer and continuation, send an acceptance letter to the social security agency in the place where the insured person's original basic old-age insurance relationship is located, and provide relevant information. Medical insurance needs to be paid for at least 25 years, and medical reimbursement will be preferential when it reaches retirement age.
The differences between primary, secondary and tertiary medical insurance are as follows:
1, the principle of medical treatment is different:
(1) The first-level insured person goes to any designated medical institution in the city for medical treatment;
(2) Filing the insured, the outpatient service is treated in the bound community health service center, the hospitalization is treated in any designated medical institution in this city, and the outpatient service is seriously ill in the prescribed medical institution;
(3) Three-level insured persons shall seek medical treatment in the outpatient department of the bound community health center, and seriously ill inpatients and outpatients shall seek medical treatment in the prescribed medical institutions.
2, general outpatient treatment is different:
(1) Class I enrollment: Personal account is used to pay the medical expenses within the scope of the insured's general outpatient medical insurance catalogue. The personal account of the basic medical expenses of community health centers pays 70%, and the overall fund pays 30% according to the regulations;
(2) Second Insured/Third Insured:
Belong to class A drugs and class B drugs, respectively, by the community outpatient fund according to the proportion of 80% and 60% payment; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.
3, hospitalization is different:
(1) First-class insured: 95% or 90% of the basic medical expenses and local supplementary medical expenses above the deductible line shall be paid as required.
(2) Second-class insured/third-class insured: you can be hospitalized in the settlement hospital bound to the social rehabilitation center, or you can refer to the designated hospital through the settlement hospital. The reimbursement rates of basic medical expenses and local supplementary medical expenses above the hospitalization deductible line are: 85% in first-class hospitals, 80% in second-class hospitals and 75% in third-class hospitals.
Legal basis:
Article 58 of People's Republic of China (PRC) Social Insurance Law
The employing unit shall, within 30 days from the date of employment, apply to the social insurance agency for social insurance registration for its employees. If the social insurance has not been registered, the social insurance agency shall verify the social insurance premium it should pay.
Employees-free individual industrial and commercial households who voluntarily participate in social insurance, part-time employees who do not participate in social insurance in the employing unit and other flexible employees shall apply to the social insurance agency for social insurance registration.
The state establishes a national unified personal social security number. Personal social security number is a citizen's identity number.
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.