Shenzhen three-level social security reimbursement scope

Legal analysis: the outpatient medical expenses incurred by the third-level insured of basic medical insurance in the selected social rehabilitation center of this city shall be handled in accordance with the following provisions:

1, Class A drugs and Class B drugs belonging to the basic medical insurance drug list are paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively;

2, belonging to the basic medical insurance directory of individual medical items or medical materials, by the community outpatient co-ordination fund to pay 90%, but the maximum payment amount does not exceed 120 yuan.

3. The outpatient medical expenses incurred by the insured due to illness, which need to be referred to other medical institutions with the consent of the settlement hospital, or the emergency rescue outpatient medical expenses incurred in non-settlement hospitals due to business trips, shall be reimbursed by the community outpatient co-ordination fund according to the provisions of the preceding paragraph. Other circumstances in the non-settlement hospital outpatient medical expenses community outpatient co-ordination fund will not be reimbursed.

4. The outpatient medical expenses paid by the community outpatient co-ordination fund to each third-level insured of basic medical insurance within one medical insurance year shall not exceed 1 000 yuan.

Legal basis: Measures of Shenzhen Municipality on Social Medical Insurance Article 2 This Municipality implements a multi-level and multi-form social medical insurance system.

The government establishes basic medical insurance and local supplementary medical insurance.

According to the payment and corresponding treatment, the basic medical insurance is divided into one, two and three forms.