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Proportion of reimbursement for medical treatment in different provinces in 2023
1, the proportion of reimbursement for medical treatment in different provinces is usually two grades, which are divided into basic reimbursement and supplementary reimbursement; Basic reimbursement: Basic reimbursement refers to the reimbursement ratio of basic medical expenses stipulated in the medical insurance system. According to national regulations, the basic reimbursement ratio is usually between 50% and 80%;
2. Supplementary reimbursement: Supplementary reimbursement refers to the expense reimbursement ratio that exceeds the basic reimbursement ratio. According to national regulations, the proportion of supplementary reimbursement is usually between 10%-20%.
For medical insurance outpatient reimbursement for medical treatment in different places, the specific situation will be different due to different countries, regions and medical insurance systems. The following are some basic principles for off-site reimbursement of medical insurance clinics in general:
1, medical insurance: First of all, ensure that you have the medical insurance qualification of the target medical area. It is usually necessary to apply for insurance in the medical insurance institution or social security bureau in the target area.
2. Medical treatment voucher: When seeking medical treatment in different places, you need to keep relevant medical treatment vouchers, such as outpatient invoices, prescriptions, medical expense lists, etc. These vouchers will be used as the basis for reimbursement.
3. Reimbursement ratio: According to the provisions of the medical insurance system, the reimbursement ratio of medical insurance clinics may vary from place to place. Generally speaking, medical insurance will be reimbursed according to a certain proportion according to specific projects and expenses. The specific reimbursement ratio can be consulted with local medical insurance institutions or insurance companies.
4. Reimbursement limit: The medical insurance system usually sets a reimbursement limit, that is, expenses exceeding a certain amount cannot be reimbursed. The part that exceeds the limit needs to be borne by the individual.
5. Reimbursement process: After medical treatment in different places, you need to keep the documents related to medical treatment, such as outpatient invoices, prescriptions, medical expense lists, etc. Then according to the requirements of local medical insurance institutions, provide the corresponding application materials and vouchers for reimbursement.
To sum up, the specific reimbursement policies of local medical insurance will be different due to different countries, regions and medical insurance systems. You can consult local medical insurance institutions or insurance companies to obtain accurate reimbursement policies, reimbursement rates, reimbursement limits and reimbursement processes.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.
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