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Can the medical insurance be reimbursed after one month's supplementary payment

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Can the medical insurance be reimbursed after one month's supplementary payment


        

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  • 2024-06-14 21:00:02

    The medical insurance cannot be reimbursed after one month's supplementary payment. Because the medical insurance is not paid normally, it is not a normal payment state, so you cannot enjoy the reimbursement treatment of medical insurance in this case. Under normal circumstances, medical insurance will directly stop the reimbursement treatment of medical insurance if the payment is interrupted for more than three months. Once the reimbursement treatment of medical insurance is stopped, If you want to recover the reimbursement of medical insurance, you must pay the medical insurance for more than 6 consecutive months before you can recover your medical insurance reimbursement.
    What's the impact of the medical insurance being cut off for a month?
    If the medical insurance payment is interrupted, the medical insurance cannot be reimbursed from the second month. That is to say, you cannot enjoy the treatment paid by the medical insurance pooling fund, but the personal balance in the social security card can still be used.
    1. Affected payment period
    If the medical insurance payment is interrupted only within three months, the continuous insurance participation time can be counted when the payment continues, but if it exceeds three months, the payment period will be reset (personal account will not be reset).
    2. Affect the treatment of seriously ill outpatient
    The basic medical expenses and local supplementary medical expenses incurred in the treatment of the minor partners who enjoy the outpatient treatment for serious diseases can be reimbursed, but the reimbursement proportion is related to the time you have continuously participated in the insurance. If you spent 20000 yuan on these two kinds of expenses when you were ill, the reimbursement ratio was 90% for medical insurance for more than 36 months, and 18000 yuan could be reimbursed. But if you were cut off one day and the payment period was cleared, the reimbursement ratio would be 60%, and only 12000 yuan could be reimbursed, which would cost 6000 yuan more.
    3. Payment limit of basic medical insurance pooling fund
    The payment limit of the basic medical insurance pooling fund in each medical insurance year is also related to everyone's insurance participation time. The longer the time is, the higher the payment limit will be. If you have been paying medical insurance all the time and suddenly cut off in the middle, your payment limit will also be reduced!
    4. Payment limit of local supplementary medical insurance fund
    Like the payment of basic medical insurance fund, the payment of local supplementary medical insurance fund is limited. The payment limit ranges from 10000 yuan to 1 million yuan, which is also a big span. Considering that tens of thousands of yuan were spent on illness, and tens of thousands of yuan could have been reimbursed, but in the end, only 10000 yuan could be reimbursed because of the break of medical insurance, which is also a loss. In fact, for medical insurance, it is only necessary to keep it for more than three months.
    5. Supplementary payment of medical insurance
    If the employer fails to participate in medical insurance for employees on time, it can apply for supplementary payment. However, the supplementary payment of medical insurance cannot exceed 2 years. The number of years after the supplementary payment can be calculated in combination. However, the medical expenses incurred before the supplementary payment are borne by the employer, and the new medical expenses incurred after the supplementary payment are paid by the medical insurance fund.
    6. Unemployment insurance payment medical insurance
    If you have paid unemployment insurance for one year and were dismissed by the company rather than leaving the company, you can apply for unemployment insurance compensation. During the period of receiving unemployment insurance compensation, the unemployment insurance fund will pay you two levels of medical insurance.
    To sum up, the medical insurance cannot be reimbursed in the current month after one month's payment. Since the medical insurance is not paid normally, it is not a normal payment status. Therefore, if the medical insurance cannot be reimbursed in the current month after one month's payment is overdue, we will not be able to enjoy the reimbursement treatment of medical insurance in this case. At the same time, if you want to recover the reimbursement of medical insurance, you must pay the medical insurance for more than 6 consecutive months before you can recover the reimbursement of medical insurance. I hope it is helpful to you. Social Insurance Law
    Article 27 An individual who has participated in the basic medical insurance for staff and workers and whose accumulated contributions have reached the number of years specified by the State when reaching the statutory retirement age will no longer pay the basic medical insurance premiums after retirement and will enjoy the benefits of basic medical insurance in accordance with the provisions of the State; Those who have not reached the time limit prescribed by the State may pay the fees to the time limit prescribed by the State.

    You***

    2024-06-14 21:00:02

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