If the medical insurance is not paid for one month, it will not affect the use within one month. From 1 day of the month following the interruption of payment, you will stop enjoying the medical insurance benefits paid by the medical insurance pooling fund, but the balance of your personal account can continue to be used. When the insured person resumes the insurance procedures, he can enjoy the prescribed medical insurance benefits from 1 day of the next month after paying the medical insurance premium. If the insured person is interrupted for no more than 3 months in the medical insurance year, the continuous insured time before and after the interruption after re-payment shall be calculated together; More than 3 months, recalculate.
Second, how to deal with the broken medical insurance:
1, medical insurance is out of supply, just need to pay it back. If you find a new job after resigning, you can ask the new unit to renew it for you. You can also apply to the local social security center to change the subject of payment, and the individual will pay the fee. And the payment must be timely, and the longer it is delayed, the more troublesome it will be.
2. If the medical insurance is cut off for one month, it will not be reimbursed from the second month, and it will also affect the payment period and the limit of reimbursement, which is generally related to our enrollment time. The longer the time, the higher the payment limit, and there is not enough time until the payment is made. If the medical insurance payment is interrupted only within 3 months, the continuous payment can be counted as the continuous participation time, but if it exceeds 3 months, the payment period will be cleared and the personal account will not be cleared. The payment limit of the basic medical insurance pooling fund in each medical insurance year is also related to everyone's enrollment time. The longer the time, the higher the payment limit. If the medical insurance has been paid all the time and is suddenly cut off in the middle, the payment limit will also be reduced.
3. If the insured fails to pay the medical insurance premium in full and on time according to the regulations, he will stop enjoying the medical insurance benefits from the month when he has never paid it in full and on time; If the payment is continued after the interruption, it must be based on the average salary of local employees in the previous year at the time of payment, and all the arrears during the interruption must be filled. The overdue time is included in the continuous payment time, but you can't enjoy the treatment of pooling funds during the overdue period. If the insured stops enjoying medical insurance benefits and pays medical insurance premiums within 60 days (including 60 days), he will enjoy the benefits paid by the overall fund from the next month of payment; Suspension of medical insurance benefits for more than 60 days to 180 days (including 180 days) to pay back medical insurance, starting from the payment month, you can enjoy the treatment paid by the overall fund three months later; If the medical insurance benefits are suspended for more than 180 days and the medical insurance premium is paid back, it will be calculated from the month of payment and enjoy the treatment paid by the overall fund after 6 months. If the payment is not made after the interruption, it will be regarded as re-participating in medical insurance, and the payment time before the interruption will not be included in the continuous payment time.
Legal basis:
People's Republic of China (PRC) social insurance law
Twenty-third employees should participate in the basic medical insurance for employees, and the employer and employees should jointly pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium 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.