Jiangsu yihuibao 1 reimbursement ratio

Legal analysis: 1. Responsibilities in basic medical insurance: Covering medical expenses paid by individuals in medical insurance and using dual-channel drugs negotiated by the state. After deducting the deductible 1 0,000, 65% will be reimbursed for 1 0,000 and below, and 77% for 1 0,000 and above, with a maximum reimbursement of 65,438+. The proportion of patients in the past decreased 10%.

2. Responsibility of basic medical insurance: medical expenses other than medical insurance incurred in hospitalization or outpatient service can be reimbursed. After deducting the deductible of 20,000 yuan, 55% will be reimbursed for the part below 6,543.8+10,000, 67% for the part above 6,543.8+10,000, and the maximum reimbursement will be 6,543.8+10,000. The proportion of patients in the past decreased 10%.

3. Re-guarantee responsibility for serious and serious diseases: the remaining personal treatment expenses after the above two expenses are reimbursed can be reimbursed under the responsibility for serious and serious diseases. After deducting the deductible of 50,000 yuan, it will be reimbursed at 45%, with a maximum reimbursement of 654.38+00,000 yuan a year, and the reimbursement rate of people with previous diseases will be reduced by 654.38+00%.

4. Supplementary protection responsibility for rare diseases: package

Including 6 rare diseases, the insured amount is 200,000, and the deductible is 45% after deducting 50,000.

Legal basis: Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers.

Twenty-eighth personal accounts are used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.

Twenty-ninth serious illness hospitalization medical expenses, according to the following methods to pay:

(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.

(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.

(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.

The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.

Thirtieth medical expenses below Qifubiaozhun and above the maximum payment limit shall not be paid by the overall fund.