What is going on with the upgrade of the medical insurance card?

The upgrade of the medical insurance card is fake.

Telecom fraudsters take advantage of people's ignorance and commit fraud. Not long ago, the Shaanxi police uncovered a fraud case that was carried out by falsely claiming to upgrade the medical insurance card.

Mr. Yin, who lives in Beilin District, Xi'an City, recently received a text message. What he didn't expect was that such a text message cost him nearly 2,000 yuan. The text message said that the medical insurance card in his name needed to be upgraded, so he clicked on the link in the text message, followed the website prompts, filled in his information, and upgraded.

After grasping the important clues, the task force immediately went to Baoding Yixian County and arrested the suspect Wang. They seized a laptop, an Internet device and three mobile phones at the scene. According to Wang's account, he privately set up a server backend in October 2021, created a medical insurance fraud website, and sent fraudulent text messages to China through overseas telecom fraud gangs and committed fraud. Based on Wang’s confession, the police also captured another suspect, Zhu, in Shanghai. When the police extracted the background data of the fraudulent website, they found that there were more than 300 victims, and the fraudulent funds amounted to more than one million yuan.

1. Medical Insurance Card

Social medical insurance card, referred to as medical insurance card or medical insurance card, is a special card for medical insurance personal accounts. It uses the personal ID card as the identification code and stores records. Personal ID number, name, gender, and detailed information such as account fund allocation and consumption status.

The medical insurance card is handled by the local designated agent bank and is a multi-functional bank debit card.

After the insured units pay the premiums, the local medical insurance department will entrust the bank to allocate the personal account funds to the personal medical insurance cards of the insured employees at the end of the month.

2. Requirements for applying for medical insurance cards

There are currently three types of social security and medical insurance cards in my country, which are aimed at different groups of people:

Urban employees can apply for the same card as their employer *** To pay for urban employee medical insurance, the condition is that urban employees, units and individuals pay the fee at the same time, and the unit needs to organize the application;

Those with urban registered permanent residence who do not have urban employee medical insurance can participate in urban resident medical insurance. Generally, Apply in the community where the household registration is located;

Farmers with registered residence can apply for the New Rural Cooperative Medical Insurance, which is usually processed at the village committee where the household registration is located.

3. Scope of reimbursement by medical insurance card

As long as you seek medical treatment and buy medicines at medical institutions and pharmacies specified by medical insurance, you can be reimbursed.

Moreover, only drugs in the "Basic Medical Insurance Catalog" can be reimbursed. All Class A drugs are reimbursed, Class B drugs are partially reimbursed, and Class C drugs cannot be reimbursed. Participation in treatment programs also has requirements. Only those that meet the scope of basic medical insurance diagnosis and treatment items can be fully reimbursed or partially reimbursed. For example, if you go to an eye hospital to get glasses, myopia surgery, etc., you do not meet the reimbursement standards.

Service facilities also have specified scope. Only medical service facilities that meet the standard scope of the basic medical insurance can be reimbursed. It mainly includes inpatient bed fees and emergency room and outpatient observation bed fees. Things such as nursing fees and meal expenses cannot be reimbursed.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 23 Employees shall participate in employee basic medical insurance, which shall be provided by the employer Units and employees must pay basic medical insurance premiums together in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexible employment personnel can participate in the basic medical insurance for employees, and individuals must pay for the basic medical insurance in accordance with national regulations. fee.