How to use Shenzhen’s second-tier medical insurance
Shenzhen’s second-tier medical insurance is an important part of Shenzhen’s basic medical insurance and is mainly for non-Shenzhen residents with flexible employment and some enterprise employees. This article will introduce in detail the usage, reimbursement ratio, scope of application, etc. of Shenzhen’s second-tier medical insurance to help you make better use of medical insurance benefits.
1. Scope of application of Shenzhen’s second-tier medical insurance
Shenzhen’s second-tier medical insurance is applicable to the following groups of people:
1. Non-Shenzhen households with flexible employment
2. Some enterprise employees (the enterprise chooses the insurance level)
3. Other qualified persons
2. Payment standards for second-tier medical insurance in Shenzhen
| Insured people | Payment base | Payment ratio | Monthly payment amount |
|---|---|---|---|
| Non-Shenzhen households with flexible employment | 60% of the average monthly salary of Shenzhen employees in the previous year | 8% | Approximately XXX yuan (specific information shall be subject to the announcement of the year) |
| Enterprise employees | My monthly salary | Enterprises pay 6% and individuals pay 2% | Calculated based on actual salary |
3. How to use Shenzhen’s second-tier medical insurance
1.Outpatient treatment:
- A social health center needs to be bound as a designated medical institution first
- You can enjoy medical insurance reimbursement when you visit the bound social health center
- The reimbursement rate is approximately 70%, with an annual limit of 1,000 yuan
2.hospitalization:
- Can be hospitalized in all designated hospitals in Shenzhen
- You need to pay the minimum payment first (1,000 yuan for a third-level hospital, 800 yuan for a second-level hospital, and 600 yuan for a first-level hospital)
- The portion exceeding the minimum payment line will be reimbursed proportionally
| Hospital grade | Deductible | Reimbursement ratio | Annual maximum payment limit |
|---|---|---|---|
| Tertiary hospital | 1000 yuan | 75% | Linked to the continuous insurance period, it can be up to 6 times the average annual salary of employees on the job in the previous year. |
| Secondary hospital | 800 yuan | 80% | Same as above |
| First class hospital | 600 yuan | 85% | Same as above |
3.Special clinic:
- Including chronic diseases such as hypertension and diabetes
- Application procedures for specific outpatient clinics are required
- The reimbursement ratio and limit are different from those of ordinary outpatient clinics
4. The reimbursement process of Shenzhen’s second-tier medical insurance
1. Outpatient reimbursement:
- Pay directly by credit card at the bound social welfare center
- The system automatically deducts the medical insurance reimbursement portion
- Only pay the personal out-of-pocket portion
2. Hospitalization reimbursement:
- Show your medical insurance card when checking in for admission
- Billed directly by the hospital when discharged
- Just pay the personal out-of-pocket portion
3. Reimbursement for medical treatment in other places:
- Need to register for medical treatment in another place in advance
- Advance medical expenses first
- After returning to Shenzhen, go to the medical insurance agency for reimbursement with relevant materials
5. Things to note about Shenzhen’s second-tier medical insurance
1. The social welfare center cannot be changed within one year after being bound.
2. Outpatient expenses not treated at a bound social health center will not be reimbursed.
3. The medical insurance card cannot be lent to others for use.
4. The period of continuous participation in insurance affects the reimbursement ratio and limit
5. The annual maximum payment limit is linked to the insurance period
6. The difference between Shenzhen’s second-tier medical insurance and first-tier medical insurance
| Compare items | Second level medical insurance | First-class medical insurance |
|---|---|---|
| Applicable people | Non-Shenzhen households with flexible employment and some enterprise employees | Shenzhen residents, employees of government agencies and institutions, and employees of some enterprises |
| Payment standard | lower | higher |
| personal account | None | Yes |
| Outpatient reimbursement | Need to be bound to the social welfare center | Common to designated medical institutions across the city |
| Hospitalization reimbursement ratio | slightly lower | slightly higher |
7. How to check Shenzhen’s second-tier medical insurance information
1. Official website of Shenzhen Municipal Medical Security Bureau
2. "Shenzhen Medical Insurance" WeChat public account
3. 12345 government service hotline
4. Service windows of various medical insurance agencies
Through the above channels, you can check medical insurance payment records, reimbursement status, designated medical institutions and other information.
8. Frequently Asked Questions
1.Q:Can I get dental treatment under the second-tier medical insurance in Shenzhen?
Answer:Yes, but only for basic treatment items. Cosmetology items are not covered by reimbursement.
2.Q:Can second-tier medical insurance be used for physical examination?
Answer:No, physical examination fees are not covered by medical insurance reimbursement.
3.Q:How to change the bound social welfare center?
Answer:You can apply for changes in January of each year, but in principle, changes cannot be made at other times.
4.Q:Can the second-tier medical insurance reimburse the cost of traditional Chinese medicine?
Answer:Yes, but it must be a traditional Chinese medicine in the medical insurance catalog.
Through the detailed introduction in this article, I believe you will have a clearer understanding of the use of Shenzhen’s second-tier medical insurance. Reasonable use of medical insurance policies can effectively reduce the medical burden. If you have more questions, it is recommended to consult your local medical insurance agency.
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