Reimbursement policy of Jinan gate regulations

As an employee's medical insurance insured, he can enjoy the treatment of medical insurance reimbursement when coordinating outpatient services and specifying outpatient diseases. Are you clear?

What is the reimbursement rate of different levels of hospitals? How exactly is it reimbursed? 20 18 Jinan official summary came ↓↓↓↓

First, general outpatient co-ordination

General outpatient co-ordination, refers to the insured in the designated general outpatient department in line with the provisions of the basic medical insurance for medical expenses deductible above the part to be reimbursed.

In a medical year, general outpatient medical expenses are paid according to the following standards:

Query website of reimbursement scope of general outpatient department: website of Jinan Social Insurance Bureau (/)-medical insurance service information

The total number of designated medical institutions in general outpatient clinics of employee medical insurance in Jinan has reached 3 13. Enquiry website: log in to official website (website:/) of Jinan Social Security Bureau "Service Guide"-"Medical Insurance Service Information"-"Directory of Designated Medical Institutions" for enquiry.

Second, the outpatient prescribed diseases

The prescribed outpatient diseases are determined by the municipal department of human resources and social security. If long-term outpatient treatment is needed, the expenses will be reimbursed by medical insurance for 23 kinds of severe chronic diseases. Directory of diseases for door regulations★ Within a medical year, the accumulated outpatient diseases and hospitalization medical expenses shall be paid according to the following standards:

In a medical year, after the medical expenses of inpatient and outpatient diseases stipulated in the basic medical insurance for insured employees are paid by the employee basic medical insurance pooling fund and large medical expenses, the part of the individual's accumulated compliance medical expenses that exceeds 6,543,800 yuan+0.2 million yuan will be paid by the pooling fund for the second time.

▲ Personal compliance medical expenses are more than 60%1.2000 yuan (including1.2000 yuan) but less than 200000 yuan;

▲ As a whole, 70% of the funds will be paid for the part of the fund that is more than 200,000 yuan (including 200,000 yuan) and less than 400,000 yuan (including 400,000 yuan).

▲ Some co-ordination funds that bear compliance medical expenses 1.2 million yuan or less and 400,000 yuan or more will not be paid.