Proportion of medical insurance reimbursement for employees in Tianjin

The reimbursement ratio of medical insurance for employees in Tianjin is as follows:

1. Basic medical insurance: In Tianjin, the reimbursement rate of employees' basic medical insurance is 50% to 80%, and the specific proportion varies according to different medical services. Among them, the reimbursement rate of hospitalization expenses is 60% to 80%; The reimbursement rate of outpatient expenses is 50% to 70%;

2. Large medical insurance: In Tianjin, the reimbursement rate of large medical insurance for employees is 85% to 90%.

The proportion of medical insurance reimbursement for employees may be different due to different medical services, different medical institutions and different individual contributions. At the same time, Tianjin also has some special regulations on employee medical insurance, such as special policies and procedures for reimbursement of certain major diseases and high medical expenses. Therefore, it is recommended that you know the specific reimbursement ratio and policy in advance when using Tianjin employee medical insurance, so as to apply for reimbursement smoothly.

Medical insurance reimbursement process:

1. Confirm reimbursement scope: During the treatment, you need to confirm whether your treatment items are within the scope of medical insurance reimbursement;

2. Collect reimbursement materials: collect relevant treatment records, drug receipts, medical expense lists and other relevant materials;

3. Go to the social security department for reimbursement: submit relevant materials for medical insurance reimbursement to the local social security department;

4. Pending review: The social security department will conduct relevant review and comparison to confirm the reimbursement ratio and reimbursement amount; Receive reimbursement: After approval, you can receive medical insurance reimbursement at the designated bank.

To sum up, to sum up, the proportion of medical insurance reimbursement in different regions is different. Urban and rural residents who have lived in different places for a long time, urban and rural residents over 60 years old and women over 55 years old, urban and rural residents who work in different places and their accompanying children have registered for medical treatment in different places. The deductible standard for hospitalization in the registered place is 400 yuan, and the first-class hospital is 800 yuan, RMB 2,000, and the reimbursement ratio is implemented according to the local designated hospital.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.