What is the proportion of medical insurance reimbursement for Zhanjiang employees?

The proportion of medical insurance reimbursement for Zhanjiang employees is as follows:

1, the expenses incurred by the insured in the hospital that meet the basic medical insurance policy shall be reimbursed by the medical insurance pooling fund according to the following proportion;

2. Payment for Class B drugs, special treatment items and special materials10%;

3. The expenses above the deductible line are 96% of the first-class hospitals and below;

4. Reimbursement of secondary hospitals is 93%, that of tertiary hospitals is 90%, and the reimbursement rate of retirees is correspondingly increased by 2 percentage points.

Participate in medical insurance for urban and rural residents and enjoy the following medical insurance benefits:

1, the expenses incurred by the insured in the hospital that meet the basic medical insurance policy shall be reimbursed by the medical insurance pooling fund according to the following proportion;

2. Payment for Class B drugs, special treatment items and special materials10%;

3, deductible above the cost, a hospital reimbursement of 90% and below; 75% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 65%, while off-campus hospitals are reimbursed 55%.

The medical insurance reimbursement process is as follows:

1. The hospitalization expenses shall be paid by the individual first. After discharge, take medical insurance card, ID card, outpatient medical records, discharge summary, total cost list (detailed list of expenses), disease diagnosis certificate, valid bill (original invoice), doctor's advice, copy of the first page of medical records, certificate issued by the school, transfer certificate and relevant certificate issued by the college to the municipal medical insurance management office for trauma treatment. For medical treatment in different hospitals, materials from different hospitals should be provided; In the same hospital, according to the different hospitalization time (before the expenses are written off, such as being treated in the same hospital after discharge), materials of hospitalization in different periods should also be provided;

2, after the opening of the credit card settlement function, the student himself or his guardian or client shall, within three days of hospitalization, go to the medical window of the service hall of the municipal medical insurance center with the student ID card, the provincial social security card, the medical record of the hospital, the certificate of disease diagnosis and the certificate issued by the college;

3. Treatment of emergency expenses of non-designated medical institutions: within 3-5 working days of emergency, first contact or entrust others to register with the municipal medical insurance management center through the student medical insurance management center of our hospital, and the medical expenses will be paid in advance by myself; At the time of reimbursement, apply for reimbursement to the municipal medical insurance center with the above reimbursement materials (non-medical insurance designated hospitals or clinics cannot be reimbursed).

In summary, the reimbursement rate of employee medical insurance is 50%; The reimbursement rate for retirees under the age of 70 is 70%; The reimbursement rate for retirees over 70 years old is 80%.

Legal basis:

Article 26 of People's Republic of China (PRC) Social Insurance Law

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.