Reimbursement ratio of rural medical insurance in Wenzhou

Wenzhou rural medical insurance reimbursement ratio 2022 medical insurance reimbursement ratio:

1. First-class hospital: Qifubiaozhun to the highest payment limit, Qifubiaozhun is 90%;

2. Secondary hospitals: 85% of the minimum threshold is 1 10,000 yuan, and 90% of the minimum threshold is 1 10,000 yuan;

3. Tertiary hospitals: the minimum deductible is 80% to 5,000 yuan, 85% to 5,000 yuan to 1 10,000 yuan, and 90% to 1 10,000 yuan to the maximum payment limit;

4, retirees on the basis of the above payment ratio increased by 5%.

Procedures and time limit for reporting hospitalization medical expenses:

In the city designated medical treatment and admission, to participate in rural cooperative medical care, you need to bring your ID card and new rural cooperative medical card for hospitalization procedures. When leaving the hospital, the hospital will make a real-time report in accordance with the relevant provisions of compensation.

Hospitalization medical expenses occurred in hospitals outside the city and above, and those who participated in the rural cooperative medical system went to the township finance office for preliminary examination with new rural cooperative medical certificate, ID card, referral form, certificate of work or visiting relatives, list of medical expenses issued by the hospital, discharge summary, original medical invoice and other materials, which were reviewed and reported by the municipal joint management office.

To sum up, there is no deductible for outpatient reimbursement, and all insured residents enjoy the treatment of general outpatient service. Within a medical insurance year, there is no deductible for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund payment are reimbursed at the rate of 60%. The annual maximum personal payment limit of co-ordination fund is 400 yuan.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

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.

People's Republic of China (PRC) social insurance law

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.