Proportion of medical insurance reimbursement for employees in Xuchang City

The proportion of medical insurance reimbursement for employees in Xuchang City is as follows:

1. According to the level of hospitalization expenses, the reimbursement rate of medical insurance for employees is between 1300 yuan and 30,000 yuan, and the reimbursement rate is 85%;

2. The reimbursement rate is 90% between 30,000 yuan and 40,000 yuan, 95% between 4 4- 10/00,000 yuan, and 85% between10-300,000 yuan;

3. Residents' medical insurance consists of urban residents' medical insurance and the new rural cooperative medical system. The reimbursement rate is 65% in a first-class hospital and 80% in a second-class hospital with more than 6,000 yuan.

4. County-level hospital deductible line 400 yuan, municipal hospital 600 yuan, county-level hospital 600 yuan.

The materials required for reimbursement of medical expenses of employees are as follows:

1. reimbursement materials for hospitalization expenses: copy of social security card, invoice, detailed summary of expenses, and diagnosis certificate (hospitalization registration form outside the autonomous region, medical records of unexpected hospitalization without third-party responsibility);

2, outpatient CT, nuclear magnetic resonance, extracorporeal lithotripsy, cardiac angiography, chronic disease reimbursement materials: invoice (invoice has no detailed requirements), copy of social security card (registration form for medical treatment in different places outside the autonomous region);

3, outpatient radiotherapy and chemotherapy, special drugs, targeted drugs reimbursement materials: invoice (invoice without the required details), copy of social security card, prescription (need to be stamped by the hospital), diagnosis certificate (outside the autonomous region need to go to different places for medical registration and filing form).

To sum up, the reimbursement rate of medical insurance for employees in Xuchang city is 85%, and the hospitalization expenses are between 1300-30000 yuan; The reimbursement rate is 90% for 30,000-40,000 yuan, 95% for 4 4- 10/00,000 yuan and 85% for10-300,000 yuan.

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.