Proportion of reimbursement for outpatient medical insurance in Nanchang

Nanchang medical insurance outpatient reimbursement ratio is as follows:

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%; For retirees over 70 years old, 80% of the expenses above 1300 yuan can be reimbursed.

However, in the following cases, medical insurance will not be paid:

1, see a doctor in a non-designated medical institution or buy medicine in a non-designated retail pharmacy (except emergency);

2, due to alcoholism, suicide, self-harm and other reasons to receive treatment;

3. Injuries caused by traffic accidents, medical accidents or other accidents;

4, because I fight, drug abuse or other illegal acts caused by their own injuries;

5, according to national or local regulations should be paid by individuals.

To sum up, the reimbursement rate of medical insurance in hospital outpatient department varies according to different medical items. Most general outpatient items can be reimbursed 50% to 70%, and some special items can be reimbursed with a higher proportion.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

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.