The establishment and implementation of the basic medical insurance system has gathered the economic strength of units and social members. With the government's funding, sick social members can get necessary material help from the society, reduce the burden of medical expenses, and prevent sick social members from "poverty due to illness".
Suzhou medical insurance "one card" has three characteristics:
First, filing does not need to be handled by individuals, realizing "zero procedures".
All insured persons in the city seek medical treatment in different places within the scope of big cities, and there is no need to go through the formalities for filing medical treatment in different places.
The second is to ensure that it is not limited by scope and is "no omission".
When all the insured people in the city seek medical treatment in different places within the scope of big cities, not only the basic medical insurance is directly settled by credit card, but also the serious illness insurance and medical assistance are simultaneously settled in real time.
Third, the organization does not set conditions to achieve "full coverage".
How to use Suzhou medical insurance card
"Suzhou Social Security Citizen Card", referred to as Suzhou Citizen Card for short, is a multi-functional composite intelligent IC card issued by Suzhou Municipal Government for registered residents and non-registered residents who participate in social insurance in this city. Used to handle personal social affairs and enjoy public services.
There are two kinds of Suzhou social security citizen cards: Suzhou citizen card A and Suzhou citizen card B.
1, Suzhou citizen card A card
Card A has the functions of social security card, Suzhou Bank debit card and small wallet. Card A is compatible with all functions of Suzhou Tongka.
2. Suzhou citizen card B card
Citizens who have not participated in Suzhou social security and need to use the e-wallet function can purchase Suzhou citizen card B by themselves. Except for social security and banking functions, Card B has the same functions as Card A and Suzhou Tongka.
Medical insurance card processing conditions:
1, Suzhou household registration personnel;
2. Non-Suzhou household registration personnel who participate in social insurance in Suzhou.
The citizen card adopts the electronic real-name registration system, with one card for each person, which is limited to my own use.
Handling materials:
1. Individuals must provide their valid identity documents (including ID card, household registration book, passport, Hong Kong and Macao pass, military officer's card, etc.). ) and a copy of their valid identity documents; If the employer applies for a unified bid, it must hold a copy of the labor security certificate or a letter of introduction from the unit, provide a copy of the applicant's personal identity certificate and fill out the Application Form for Suzhou Citizen Card Unit;
2. If the applicant is a foreign employee, relevant work certificates must also be provided;
3. Provide a recent 2-inch color bareheaded photo on a white background;
4. The applicant shall fill in, read and check the Application Form for Suzhou Citizen Card Unit, and sign it for confirmation.
Time limit for processing:
The business card printing cycle of social security citizen card is 30 days. When a unit or individual receives a card from the designated social security citizen card service center, the agent of the unit must show the letter of introduction of the unit and his ID card. Individuals who receive cards in person must show their identity cards; If you entrust others to receive the card, you must show the identity cards of the principal and the principal at the same time;
The card replacement period is 7 days, and you must show your ID card and business documents when you take the card.
Handling fee:
It is free to apply for social security citizen card for the first time; If the social security citizen card is damaged by non-human factors and personal information needs to be changed due to non-personal factors, the card can be changed for free; You need to charge a replacement fee for the replacement card.
Handling location:
Units or individuals to the designated social security citizen card service center to receive the card.
The use of personal account funds
1, which is used to pay the outpatient medical expenses of employees' medical insurance participants;
2. After the accumulated balance of the personal account in the previous year is carried forward to the next year, it can be used for the settlement and payment of outpatient medical expenses, and can also be used for the individual's own part of hospitalization medical expenses.
3. Persons whose personal medical insurance account balance exceeded 3,000 yuan in previous years may apply to transfer part of the funds to the Sunshine Fitness Card for fitness consumption, or purchase designated commercial health insurance products for themselves and their immediate family members.
4. After the medical expenses of quasi-branded drugs, medical equipment (consumables) and diagnosis and treatment items occurred by the insured in designated medical institutions are paid according to the provisions of medical insurance, the part of the personal account balance exceeding 6,000 yuan in previous years and the self-funded medical expenses will be paid directly and automatically from the part of the personal account balance exceeding 6,000 yuan in previous years.
5. For enterprise retirees who implement the socialized distribution of pensions in different places (excluding those who enjoy the medical treatment of specific outpatient items and those who have gone through the settlement registration procedures for medical treatment in different places), after the account is updated by the Municipal Social Security Center in April each year, the pre-planned amount of personal accounts in that year and the balance of personal accounts in previous years will be paid to individuals in one lump sum through the socialized distribution channels of pensions.
legal ground
People's Republic of China (PRC) social insurance law
Article 2 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 in case of old age, illness, industrial injury, unemployment and maternity.
Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Article 25 The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.