Can medical insurance designated pharmacies swipe medical insurance cards?

You can use the medical insurance card for reimbursement when you buy medicine at the designated medical insurance pharmacy, but it depends on what medicine you buy.

Scope of use of medical insurance card: When insured employees buy medicines in designated hospitals and pharmacies, they can swipe their cards on POS machines with their passwords. However, drugs in general pharmacies are divided into two categories: drugs listed in medical insurance and drugs listed in non-medical insurance.

Among them, the drugs in the medical insurance catalogue include three categories: medical insurance A, B and C. A drug 100% can be fully included in the scope of reimbursement, B drug can be included in a certain proportion, and C drug can be fully paid at its own expense (not included in reimbursement). Among them, the category A catalogue is unified nationwide; As for the category B catalogue, the provinces and cities can adjust it to no more than 15%. This means that the reimbursement scope of each province and city will be slightly different. For example, buying drugs listed in Class A and B of medical insurance is to use the overall fund of medical insurance. Therefore, if you buy medicine with a medical insurance card, you should also provide a medical record to let the pharmacy confirm whether the medicine is correct. For class C medical insurance drugs, you can show your medical insurance card and swipe your card directly. Because it is self-funded, it is not reimbursed as a whole. At this time, the personal account in the medical insurance card is used.

The medical insurance card can only be used in hospitals, not in pharmacies. There are two main situations:

1. The medical insurance personal account is out of money.

We don't have to swipe the medical insurance card at the designated medical insurance pharmacy to buy medicine, but pay with the money in the employee's personal medical insurance account. Personal account balance is 0, so you can't buy medicine by credit card. Therefore, if you want to buy medicine with a medical insurance card, you must first ensure that you have money in your personal account.

2. There is no personal account for the insurance paid.

Urban and rural residents' medical insurance contributions are low, and there are only overall accounts, but no personal accounts. The overall account is mainly used for reimbursement of medical expenses such as hospitalization, referral from different places, outpatient chronic diseases or special diseases. , but can't pay the individual's own expenses.

Legal basis:

People's Republic of China (PRC) social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

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.