Chengdu medical insurance reimbursement rate is how

Outpatient:Reimbursement rate:70% for hospitals and 90% for communities for the portion above 1800 RMB, and the ceiling line:20,000 RMB. Hospitalization:90% of the standard for first-class hospitals, 87% of the standard for second-class hospitals, 85% of the standard for third-class hospitals, and a total of 300,000 yuan reimbursement for hospitalization.

A. What is the reimbursement rate of Chengdu health insurance?

Generally speaking, the economic development of different regions is different, so the reimbursement rate also varies, the following on the Chengdu employee health insurance insurance ratio situation is explained.

After the medical insurance, if you are an active employee, you can only be reimbursed for medical expenses above 1800 RMB after visiting the outpatient and emergency clinics of the hospital, and the reimbursement rate is 50%. If you are a retiree under the age of 70, you can be reimbursed for expenses over $1,300, and the reimbursement rate is 70%. If the retiree is over 70 years old, expenses over $1300 can be reimbursed the reimbursement rate is 80%.

And regardless of the category, the maximum amount of expenses paid for outpatient and emergency major medical expenses is 20,000 yuan. For example, if you are an active employee and spend $2,500 on an outpatient visit, then 50% of the $700 portion can be reimbursed, which is $350.

Second, non-Chengdu rural household registration in Chengdu to participate in the employee social security, medical insurance hospitalization reimbursement rate is how much?

The basic urban workers' medical insurance hospitalization medical treatment has nothing to do with the household registration of the insured person. Participants in the designated medical institutions incurred in accordance with the provisions of the one-time hospitalization medical costs, the amount of the coordinated fund above the starting standard part, after deducting the individual first out-of-pocket expenses, by the coordinated fund according to the level of hospitals in accordance with the proportion of the payment: 85% of third-class hospitals, 90% of second-class hospitals, first-class hospitals 92%, and 95% of the community health centers with the medical insurance agency signed a hospitalization medical service agreement. On top of that, 2% is added for those who have reached the age of 50, 4% for those who have reached the age of 60, 6% for those who have reached the age of 70, 8% for those who have reached the age of 80, and 10% for those who have reached the age of 90. The percentage of reimbursement of medical expenses after the increase based on age shall not exceed 100%.

Three: What is the scope of non-reimbursement of Chengdu Medical Insurance?

1, self-medication (without designated hospitals or referral orders), self-purchase of medicines, public medical provisions can not be reimbursed for medicines and not in line with the family planning of medical expenses;

2, outpatient treatment costs, clinic fees, hospitalization fees, food, companion fees, nutritional costs, blood transfusion costs (except for those who have a family blood bank, reimbursed in accordance with the relevant provisions), air conditioning, ambulance charges, special nursing costs and other expenses

3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice;

4. Orthopedics, plastic surgery, dentures, prosthetics, organ transplants, named surgery fees, consultation fees, etc.;

5. Reimbursement of expenses within the scope of reimbursement, but outside the limit.

Four, hospitalization medical insurance reimbursement process and what are the precautions?

1, admitted or discharged must hold a health insurance IC card to the designated medical institutions health insurance management window for hospital registration procedures. When you are hospitalized, you will have to pay a deposit in advance, and then you will have to pay more or less after you are discharged from the hospital. Medical fees incurred before hospitalization registration are not covered by basic medical insurance. If you are hospitalized due to an emergency and cannot register for hospitalization in time, you should go to the medical insurance management window on the next day after you are admitted to the hospital with a certificate of emergency to make up for the hospitalization (if postponed on holidays), and you will be responsible for the medical fees that exceed the time limit.

2, the participants hospitalized in the integrated fund of the starting line: the starting line of standards vary from place to place is generally 10% of the average annual salary of the city's employees in the previous year, in a basic medical insurance settlement year, multiple hospitalization of the medical costs are calculated cumulatively.

3, the insured person needs to be referred or transferred to the hospital due to the condition, must be diagnosed by the deputy director of the three or more designated medical institutions or the director of the proposed referral (hospital), the unit to fill out an application form, the designated medical insurance management department of the medical insurance agency agreed to report to the municipal (district) social security agencies for approval after the referral (hospital) procedures.

In summary, Chengdu workers to the hospital to see a doctor, to choose the medical insurance designated hospital, so that the reimbursement will be more. Chengdu medical insurance reimbursement rate is between 50% and 80% depending on the age of the applicant and the level of the hospital. There is a limit to the total amount of reimbursement here, of which outpatient reimbursement cannot exceed 20,000 per year. Medical insurance is an important social security for employees, and you must learn to use it.