Shenzhen first-class medical insurance outpatient use

Shenzhen social security grade difference is also in the medical insurance, one, two, three different treatment, Shenzhen first class medical insurance is the most paid, of course, treatment is also the best! So, what diseases can be reimbursed by the Shenzhen first-class medical insurance? The first is to make sure that you have a good understanding of the situation, and that you have a good idea of what you are doing.

Reimbursement scope

1, personal account for outpatient basic medical expenses, local supplementary medical expenses, in the designated retail pharmacies to buy medical insurance catalog range of drugs.

2. If an individual's out-of-pocket expenses exceed 5% of the average salary of on-the-job workers in Shenzhen in the previous year within the same medical insurance year after one year of continuous enrollment, the excess will be paid by the Basic Medical Insurance Fund for Major Diseases or the Local Supplementary Medical Insurance Fund in accordance with the regulations, 70%, and 80% for those above the age of 70.

3. If the accumulated amount in the individual account exceeds 5% of the average salary of on-the-job workers in Shenzhen in the previous year, the exceeding part can be used to pay the following expenses:

The expenses for purchasing non-prescription drugs within the scope of the catalog of drugs of the basic medical insurance and the local supplemental medical insurance in the fixed-point retail pharmacy by the person himself/herself and his/her spouse and the immediate family members of the person who have already taken part in basic medical insurance in Shenzhen are paid out of pocket at the fixed-point medical institution when he/she goes for medical treatment. Out-of-pocket expenses for basic medical care and local supplementary medical care at designated medical institutions

Expenses for health checkups, preventive vaccinations and other prescribed expenses for the participant, his/her spouse and immediate family members who are covered by the city's basic medical insurance

Note:

Participants who are entitled to the treatments stipulated in the preceding paragraph shall not be entitled to the following treatments:

Basic medical insurance first tier The basic medical expenses and local supplementary medical expenses incurred by the insured person in the designated social health center in Shenzhen, 70% of which will be paid by his personal account, and 30% will be paid by the basic medical insurance fund for major illnesses and the local supplementary medical insurance fund in accordance with the provisions of the Basic Medical Insurance, except for the costs of the following items:

1) the cost of stomatological treatments;

2) the cost of rehabilitation and physical therapy;

3) the cost of large-scale medical The cost of large-scale medical equipment examination and treatment;

4 other items prescribed by the municipal government.

3. Basic medical insurance first class participants personal account accumulation exceeds the average salary of on-the-job workers in Shenzhen in the previous year (the current standard: 4918 yuan / month) 5%, the excess can be used to pay for the following costs:

①I purchase at designated retail pharmacies in the basic medical insurance and local supplemental medical insurance drug catalog range of over-the-counter medicines;

①I and his or her has been participating in the medical equipment examination and treatment costs;

4 municipal government provides other items of cost.

4.

②I and my spouse and immediate family members who have participated in the city's basic medical insurance in the designated medical institutions to pay the basic medical expenses, local supplementary medical expenses;

③I and my spouse and immediate family members who have participated in the city's basic medical insurance health checkups, vaccination costs;

④State, Guangdong Province, and the city of the provisions of the other medical expenses.

Shenzhen medical insurance first class designated community health center reimbursement treatment

1. Basic medical insurance first class participants in Shenzhen designated community health center of basic medical expenses and local supplementary medical expenses, 70% of its individual account to pay, 30% of the basic medical insurance fund, local supplementary medical insurance fund in accordance with the provisions of the Fund, except for the following costs:

1) the cost of basic medical insurance and local supplemental medical expenses.

①Stomatology treatment costs;

②Rehabilitation physiotherapy costs;

③Large-scale medical equipment inspection and treatment costs;

④Other items prescribed by the municipal government costs.

2. 80% of the basic medical expenses and local supplementary medical expenses incurred for large-scale medical equipment inspection and treatment in outpatient clinics of designated medical institutions in Shenzhen for first-tier participants of basic medical insurance shall be paid by the Basic Medical Insurance Fund for Major Diseases and the Local Supplementary Medical Insurance Fund in accordance with the regulations.

Shenzhen basic medical insurance outpatient treatment

1. Participants with one of the following circumstances, enjoy the outpatient treatment of major diseases:

① chronic renal failure outpatient dialysis;

② included in the scope of medical insurance payments for organ transplantation outpatient anti-rejection medication;

3 malignant tumors outpatient chemotherapy, interventional therapy, radiation therapy or Nuclear therapy;

4 hemophilia specialist outpatient treatment;

5 aplastic anemia specialist outpatient treatment;

6 thalassemia specialist outpatient treatment;

7 benign intracranial tumors specialist outpatient treatment;

8 municipal government approval of the other cases

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