Shijiazhuang medical insurance outpatient reimbursement policy 2022

Legal analysis: According to the overall policy of medical insurance outpatient service for employees in Shijiazhuang, common diseases in outpatient service for employees can also be reimbursed. The first-level and below medical institutions are in 700 yuan, the second-level medical institutions 1 0,000 yuan, and the third-level medical institutions 1, 500 yuan. The reimbursement rate is 80% for first-class and below medical institutions, 70% for second-class medical institutions and 60% for third-class medical institutions; The annual reimbursement limit is 2,500 yuan for employees 1500 yuan and retirees.

Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation. The process required for medical insurance reimbursement is as follows: 1, inpatient medical records; 2. Cost list; 3. Hospitalization invoice; 4. Summary of discharge; 5. Disease diagnosis; 6. ID card and household registration book; 7, cooperative medical book (or card, card); 8. Transfer procedures or certificates (work certificate or emergency certificate). The social security department of the unit shall apply for reimbursement at the designated place with the required information, and truthfully fill in the medical expense reimbursement information registration form.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.