什么情况下医保可以使用公司缴纳的部分

2025-02-26 06:52:17
推荐回答(3个)
回答(1):

以下情况下医保可以使用公司缴纳的部分:
1、看门诊用来刷卡付费;
2、是药店买药;
3、是住院时出示有医保,然后住院费用自动划走(除去自付的部分,报销80%);报销的比例是由个人和公司共同承担费用,公司8%,个人2%。医保个人账户是根据基本医疗保险政策而设立的、专门用于存储参保人缴纳的医疗保险费和用人单位缴费中按一定比例划入的资金,记录医疗消费情况的专用账户。个人账户的资金用于支付就医和购药自付部分的费用。社会保障卡是由医疗保险经办机构为参保人就医、购药而办理的用于验明身份,记录、储存个人账户资金及使用情况的电子信息卡片。参保人持本人社会保障卡,可在本市任何一家定点医疗机构就医或定点零售药店购药。医保报销城镇医疗保险报销范围是指城镇所有用人单位,具体如下所示:
1、包括企业(国有企业、集体企业、外商投资企业、私营企业等);
2、机关、事业单位、社会团体、民办非企业单位及其职工,都要参加基本医疗保险;
3、有些城镇规定乡镇企业及其职工、城镇个体经济组织业主及其从业人员要逐步纳入基本医疗保险范围(最后一条根据每个地方不同政策而定)便可以享受医疗报销。
城镇医疗报销的主要是指是在医院看病、用药、住院、手术等,可以通过医保卡按照相关规定可以进行医药费用的报销,城镇医疗保险比较专一,项目规模和覆盖面较大,但其在重大疾病或意外事故方面赔付有限,这个时候笔者建议参保人可另行购买商业大病医疗补充保险与社保进行组合的方式,来减轻自己的经济损失。
《中华人民共和国社会保险法》第二十八条 符合基本医疗保险药品目录、诊疗项目、医疗服务设施标准以及急诊、抢救的医疗费用,按照国家规定从基本医疗保险基金中支付。
第二十九条 参保人员医疗费用中应当由基本医疗保险基金支付的部分,由社会保险经办机构与医疗机构、药品经营单位直接结算。社会保险行政部门和卫生行政部门应当建立异地就医医疗费用结算制度,方便参保人员享受基本医疗保险待遇。

回答(2):

医保卡里的钱只是个人账户的钱(自交的)
个人账户的钱只能是住院、门诊或者买药才可以用。
统筹报销的必须是住院才可以用(白给的)
住院费用一般是统筹报销一部分自费一部分(自费部分可以用医保卡交)不够的部分交现金
至于你问的单位交的哪去了?答案是交给国家统筹了,也就是去给别人看病报销了,保险就是互助的,别人有事时你帮他,你有事时别人帮你!善有善报的具体体现!

回答(3):

使用如下:
一、看门诊用来刷卡付费;
二、是药店买药;
三、是住院时出示有医保,然后住院费用自动划走(除去自付的部分,报销80%);
报销的比例是由个人和公司共同承担费用,公司8%,个人2%;
正常情况下,患病需要住院时,拿上医保卡、病历本到自己的定点医院,即可用医保卡结算。也就是自费部分自己交(个人帐户),报销部分医保中心和医院结算(统筹帐户)。

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