The household registration is medical insurance for urban and rural residents in Lingling District. How much can be reimbursed for hospitalization in lengshuitan Hospital of Yongzhou Central Hospital?

First-class hospital: 300 yuan, deductible line, no compensation expense segmentation, reimbursement rate of 65%.

Secondary hospitals: 400 yuan, the deductible line of county secondary hospitals, the reimbursement rate of compensation expenses below 6,000 yuan is 65%, and the reimbursement rate of compensation expenses above 6,000 yuan is 80%. 600 yuan, the city's second-level hospital deductible line, 65% for reimbursement below 6000 yuan, and 80% for reimbursement above 6000 yuan.

Third-level hospitals: 600 yuan, the deductible line of county-level third-level hospitals, the reimbursement rate of compensation expenses is less than 6,000 yuan, and the reimbursement rate of more than 6,000 yuan is 80%. In 800 yuan, 55% of the compensation expenses are below 12000 yuan, and 75% are above 12000 yuan.

At present, medical insurance is a municipal overall plan, and the medical insurance policies in different cities are different. I need to consult the medical insurance service center where I am insured, and the staff will give accurate and specific answers according to my situation and policies and regulations.

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Medical Insurance Reimbursement The scope of urban medical insurance reimbursement refers to all employers in cities and towns, as shown in the following figure:

1. Including enterprises (state-owned enterprises, collective enterprises, foreign-invested enterprises, private enterprises, etc.). );

2 organs, institutions, social organizations, private non-enterprise units and their employees shall participate in the basic medical insurance;

3. Some towns and villages stipulate that township enterprises and their employees, owners of urban individual economic organizations and their employees should be gradually incorporated into the basic medical insurance coverage (the last one depends on different local policies), so that they can enjoy medical reimbursement.

Urban medical reimbursement mainly refers to medical treatment, medication, hospitalization, surgery, etc. And medical expenses can be reimbursed by medical insurance card in accordance with relevant regulations. Urban medical insurance is relatively specific, with large project scale and coverage, but limited compensation for major diseases or accidents. At this point, the author suggests that the insured can purchase commercial supplementary medical insurance and social security to reduce their economic losses.

Introduction to medical insurance:

Medical insurance refers to social medical insurance. It is a social insurance system that meets the basic medical needs of the state and society according to laws and regulations when workers are sick.

20 16 65438+ 10/2 the State Council issued "opinions on integrating the basic medical insurance system for urban and rural residents" to promote the integration of medical insurance for urban residents and the new rural cooperative medical system, and gradually establish a unified national medical insurance system for urban and rural residents.

On February 20th, 2065438+0616, Ministry of Human Resources and Social Security held a video conference on the nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, and signed letters of responsibility with the first batch of 22 provinces including Beijing, which applied for nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, marking the formal implementation stage of direct settlement of medical treatment in different places.

According to the statistical bulletin of June 20021year, the number of people participating in the national basic medical insurance in 2020 is 136 13 1 10,000, and the participation rate is stable at over 95%.

With the characteristics of "low level and wide coverage", the payment is based on the cost that most units and individuals can bear at a low level, covering all units and employees in cities and towns, and employees of different units can enjoy the rights of basic medical insurance.

The insured can enjoy it for life after completing the payment period. Secondly, the basic medical insurance has the characteristics of "the burden of both parties and the combination of unified accounts"; Based on the principle of "balance of payments".