Can the money in my medical insurance card be used to buy medicine for my loved ones? Answer from the National Medical Insurance Administration

2024-05-09

Recently, the National Medical Insurance Administration released an article titled "This kind of small favor cannot be helped, using someone else's medical insurance card will be punished!" which has attracted the attention of many netizens. The National Medical Insurance Administration has sorted out and answered some questions. Q: Can the money in my medical insurance card be used by my family? Answer: If the money in the employee medical insurance card you mentioned refers to the balance of the individual medical insurance account, this is acceptable. After participating in employee medical insurance, the personal account "Family Assistance" can be authorized to be used by insured parents, spouses, and children, such as for paying the self paid portion of compliant medical expenses. For example, Li Ming's son Li Xiaoming fell ill, and Li Xiaoming had to personally bear 100 yuan for medical treatment and medication. There is still a balance in Li Ming's employee medical insurance personal account. After applying for family assistance, Li Xiaoming can use the money in Li Ming's employee medical insurance personal account to pay the 100 yuan, which is called family assistance. Q: How to handle "family assistance"? Answer: The insured (generally the people who help each other) can achieve online processing through the functional modules of "individual account and family assistance for medical insurance of employees" such as the local special area of the national medical insurance service platform APP, the WeChat official account of the local medical insurance department, and the official website. The specific way is open to the public by the medical insurance departments in each planning area; Special groups such as the elderly who have difficulty operating smart devices can also apply for it in the offline medical insurance hall. Q: Can family members use "family assistance"? Answer: No, it's not. Only family members who have applied for employee medical insurance personal account family assistance can enjoy the personal account family assistance policy. For example, Li Ming's mother, son, and father-in-law all participate in employee medical insurance, and their personal accounts have balances. Among them, only his son and Li Ming handled family assistance, and Li Ming could only use the balance of his son's personal account for payment of expenses. My mother's account cannot be used for mutual aid payments due to not having a personal account for employee medical insurance. My father-in-law does not belong to the category of family members and cannot handle family assistance. The personal account fund in the employee medical insurance card of the insured can be used by parents, spouses, and children, but it must meet two prerequisites: first, your parents, spouses, and children have also participated in basic medical insurance (including employee medical insurance and resident medical insurance); Secondly, you have applied for a personal account for employee medical insurance and family assistance. At the same time, it should be noted that: firstly, family members do not include the parents of their spouses; The second reason is that the insured person cannot enjoy the medical insurance reimbursement benefits of the insured person, that is, you can use the money in your personal account with your parents, but the amount that your parents can report for medical treatment still depends on the medical insurance system they participate in. Those who participate in employee medical insurance will enjoy the corresponding benefits of employee medical insurance; Those who participate in resident medical insurance will enjoy the corresponding benefits of resident medical insurance. Q: After applying for "family assistance", who should use their medical insurance card for medical treatment and medication? Answer: In any case, when seeking medical treatment or purchasing medication, the patient's own medical insurance card must be used. The family mutual aid policy refers to the money in the personal account of the employee medical insurance participant's medical insurance card, rather than the medical insurance card itself. The principle followed by medical insurance is that "if you participate in the insurance, you will enjoy the benefits.". After family assistance, this principle remains unchanged, and insured individuals still use their own medical services

Edit:GuoGuo    Responsible editor:FangZhiYou

Source:gmw.cn

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