Where to complain about Jiangxi Medical Insurance Center

1.

The medical insurance complaint center can go to the municipal medical insurance management center at the next higher level to complain, and can also go to the labor and Social Security Bureau or petition complaints

generally, the reimbursement of medical insurance is approved by the medical insurance center in strict accordance with the national and local standards. If the parties do not understand or accept, they can raise an objection and appeal to the higher management center. Medical insurance means that the basic medical insurance premium should be paid in full and on time by the employing unit and indivial employees according to the principle of compulsory social insurance through national legislation. If they fail to pay in full and on time, their personal accounts will not be counted, and the basic medical insurance co-ordination fund will not pay their medical expenses

2. The medical insurance complaint center can go to the municipal medical insurance management center at the next higher level to complain, and can also go to the labor and Social Security Bureau or petition complaints. Usually, the medical insurance center in the approval reimbursement of medical insurance, is in strict accordance with the national and local standards, if the parties do not understand or do not accept, can raise an objection to the higher management center.

3. The superior department of the medical insurance center is the human resources and Social Security Bureau (Labor Bureau), which directly goes to the labor bureau to complain

4.

Article 1 in order to solve the problem of medical expenses payment above the annual maximum payment limit of the basic medical insurance co-ordination fund for urban residents, rece the burden of medical expenses for serious illness of insured residents, establish and improve the multi-level medical security system in Jiangxi Province, and standardize and improve the work of supplementary medical insurance for serious illness of urban residents, We will promote the smooth implementation of the basic medical insurance system. According to the opinions of the CPC Central Committee and the State Council on deepening the reform of the medical and health system (Zhong Fa [2009] No. 6), the guidance of the State Council on carrying out the pilot project of basic medical insurance for urban residents (Guo Fa [2007] No. 20), the These measures are formulated according to the spirit and requirements of guiding opinions of Jiangxi Province on promoting basic medical insurance for urban residents (gftf [2007] No. 31) and notice of General Office of Jiangxi Provincial People's Government on transmitting guiding opinions of General Office of the State Council on bringing college students into the pilot scope of basic medical insurance for urban residents (gftf [2009] No. 13). Article 2 supplementary medical insurance for serious illness of urban residents (including college students) (hereinafter referred to as residents' supplementary medical insurance) refers to a kind of supplementary medical insurance of the basic medical insurance system for urban residents, which is matched with the basic medical insurance system for urban residents. Its main function is to pay high medical expenses that exceed the maximum payment limit of the overall planning fund for basic medical insurance for urban residents, The residents should supplement the medical insurance and give some compensation. Article 3 in principle, the supplementary medical insurance for residents shall be coordinated at the level of cities divided into districts. The administrative departments of human resources and social security at all levels are responsible for the management, guidance and supervision of residents' supplementary medical insurance. Article 4 the supplementary medical insurance for residents may be undertaken by the bidding commercial insurance company entrusted by the human resources and social security administrative department of the overall planning area. The administrative department of human resources and social security of the Coordinating Region shall report the bidding scheme to the medical insurance Department of the Provincial Department of human resources and social security for examination and approval in advance. Article 5 the supplementary medical insurance expenses of residents shall be paid by families or indivials in accordance with the principle of fixed income, balanced income and expenditure and slight savings. The payment standard for supplementary medical insurance of residents (regardless of alts and minors) shall be no less than 20 yuan per person per year. Article 6 the supplementary medical insurance premium for residents shall be paid by the insured together with the basic medical insurance premium for urban residents. College students and primary and secondary school students participating in residents' supplementary medical insurance premium shall be paid together with the basic medical insurance premium of urban residents by the school as a unit, and shall be collected and paid by the school. Article 7 the supplementary medical insurance expenses of residents shall be calculated and managed separately. Residents' supplementary medical insurance expenses shall not be disbursed from the overall planning fund of basic medical insurance for urban residents. Article 8 if the administrative department of human resources and social security of the coordinating region entrusts the winning commercial insurance company to undertake the supplementary medical insurance for residents, the medical insurance agency of the coordinating region, as the group policyholder participating in the supplementary medical insurance for residents, shall take out the insurance from the commercial insurance company and sign an agreement to clarify the rights, obligations, responsibilities and entrustment time limit of both parties. The agreement shall be submitted to the medical insurance Department of the Provincial Department of human resources and social security by the medical insurance agency of the coordinating region and put on record by the provincial social security center. Article 9 the supplementary medical insurance for residents shall be implemented in accordance with the "three catalogues" and relevant provisions of the basic medical insurance for urban residents, including the drug catalogue, the diagnosis and treatment project catalogue, the scope of medical service facilities and the payment standard. If the medical expenses exceed the scope of the "three catalogues" and the relevant provisions of the basic medical insurance for urban residents, the supplementary medical insurance for residents shall not be paid. Article 10 if the medical expenses of insured residents exceed the annual maximum payment limit of urban residents' basic medical insurance co-ordination fund and conform to the payment scope of urban residents' basic medical insurance, the residents' supplementary medical insurance shall be paid according to the following standards: the payment standard of medical institutions is 90% in the first level, 85% in the second level, 80% in the third level, 70% in the insured year, The cumulative maximum payment limit of residents' supplementary medical insurance in the year is no less than 6 times of the disposable income of urban residents (including basic medical insurance expenses). The year of residents' supplementary medical insurance is the same as that of urban residents' basic medical insurance. Article 11 the reimbursement payment process of residents' supplementary medical insurance shall be determined by each coordinating region according to the principle of convenient for the masses and settlement. Article 12 the commercial insurance company that underwrites shall set up a payment window for residents' supplementary medical insurance benefits in the service hall of the medical insurance agency, provide business consultation, timely accept compensation applications and pay medical expenses. The handling business and medical insurance services of residents' supplementary medical insurance are subject to the supervision, management and business assessment of medical insurance agencies in the overall planning area

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5. We also met this incident, because at that time, the family patients were transferred to the hospital in the emergency department, and they didn't inform the medical insurance bureau, so they couldn't report anything after seeing a doctor. It's really irritating. What life brings in is ignorance. We pay medical insurance every year, just to have a guarantee for ourselves. In this case, the medical insurance bureau should tell the common people that they must say hello to the hospital, We would not have suffered so much.

6. Hello, are you talking about Jiangxi social insurance management center? The address is: No.58 Zhongshan West Road, Nanchang
if you agree, please accept.

7. No one answered the phone. Maybe when you called, it happened that the person in the office was not in the office, went out to do other business, or went to the bathroom, went to a meeting, etc. you can try again at another time, more understanding, more tolerance

8. You can directly complain to the Local Social Security Bureau medical insurance center
the application scope of the medical insurance card mainly includes the following three aspects:
1. It is used for purchasing medicine: when the insured buy medicine in the designated drugstore, they can pay with the medical insurance card
2. For reimbursement: medical insurance card can be used for reimbursement if you go to the hospital to see a doctor, whether outpatient or inpatient, and reach the starting line of medical insurance and are within the scope of medical insurance reimbursement
3. For medical treatment: when the participants are sick, they can use the medical insurance card and medical insurance manual to go to the designated hospital for registration and treatment. The main process is as follows: holding medical insurance manual and medical insurance card - registration of medical insurance office of hospital - Verification of certificate card - payment of deposit for hospitalization - hospitalization - approval and signature of self funded projects by patients - cash or medical insurance card.

9. Jiangxi Social Insurance Management Center
address: No.58, Zhongshan West Road, Nanchang City postcode: 330025

consulting telephone: endowment insurance 0791-86658525
medical, work-related injury Maternity insurance 0791-86658529

public service telephone: 12333
business consultation telephone at provincial level:
0791-86658573
0791-86658575
0791-86658576
0791-86658502
0791-86658507