Proportion of social security card reimbursement for children aged 0-6

First, the proportion of hospitalization reimbursement for children's medical insurance

1, hospitalization medical insurance benefits. Within one year, the first-class hospital (community health service center) will not set the deductible line for hospitalization medical expenses below 6.5438+0.8 million yuan, and will be reimbursed 65%; 300 yuan, the deductible line of the secondary hospital, reimbursed 60%; 500 yuan, the deductible line of tertiary hospital, will be reimbursed by 55%.

2, outpatient special disease reimbursement treatment. The deductible line for outpatient special diseases within one year is 300 yuan, and the highest payment limit and reimbursement ratio are implemented according to the hospitalization reimbursement standard. Special outpatient diseases include: renal dialysis, anti-rejection after renal transplantation, tumor radiotherapy and chemotherapy analgesia, diabetes, cor pulmonale, lupus erythematosus, hemiplegia, psychosis, hemophilia, anti-rejection after liver transplantation, epilepsy, aplastic anemia and chronic thrombocytopenic purpura.

3, emergency reimbursement treatment. Within one year, the deductible line of emergency medical expenses incurred by urban and rural residents in first-class hospitals (including community health service centers) is 800 yuan, with the maximum payment limit of 3000 yuan and 30% subsidy.

Four, students' accidental injury additional insurance benefits. On the basis of the basic medical insurance for urban and rural residents, a unified supplementary insurance for accidental injuries of students and children will be established to solve the problems of medical expenses compensation, disability and death subsidies for students and children due to accidental injuries.

Second, what is the use of the child's social security card?

In fact, children's social security card is also a medical benefit provided by the state. It is also to solve the medical reimbursement and compensation in risk situations such as diseases. It's good to apply for a child social security card.

For children who apply for social security cards, the deductible line for emergency medical expenses incurred by urban and rural residents in a first-class hospital (including community health service center) within one year is 800 yuan, with a maximum payment limit of 3,000 yuan and a subsidy of 30%.

3. What are the scope of reimbursement for children's social security and medical insurance?

Many diseases of children are congenital and acquired, including many diseases, but what can be reimbursed! Generally speaking, the scope of reimbursement for children's medical insurance includes three aspects.

1. Outpatient medical expenses: After the insured purchases children's medical insurance, the outpatient medical expenses caused by common diseases or serious illnesses or the expenses of treatment in designated medical institutions can be reimbursed. Among them, leukemia, hemophilia aplastic anemia and organ transplantation are all within the scope.

2. Special drug expenses: If the insured children are in a medical year, after all, the prices of many special drugs are very high, and the special drug expenses incurred according to the regulations can be reimbursed by children's medical insurance.

3. Hospitalization medical expenses: If the insured child needs emergency rescue and hospitalization due to illness, it can be reimbursed. If the expenses incurred by the hospital can be reimbursed, they can be reimbursed according to the prescribed proportion. The medical expenses incurred must meet the basic medical insurance stipulated by the local authorities, and all of them can be reimbursed.

legal ground

People's Republic of China (PRC) Social Insurance Law Article 25 The State establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.