What is the deductible line for outpatient reimbursement?

Legal analysis: there is a deductible for medical insurance reimbursement, and the part below the deductible must be borne by yourself. The deductible lines of outpatient and inpatient are different, and the deductible lines in different regions are also different. Different hospitals have different deductible lines. Generally, the deductible line is set at 300- 1800 yuan.

The medical insurance reimbursement policy is as follows:

1. The medical insurance is divided into two accounts, the personal account, and the money reflected by the medical insurance card can be used to buy medicines at designated pharmacies, and the individual pays for outpatient expenses and hospitalization expenses; The overall account is managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement are paid by the overall account.

2. When seeking medical treatment, show the medical insurance card to the designated hospital to prove the identity and registration of the insured. The part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay in advance before reimbursement. At the time of checkout, the part paid by the individual is paid by the balance of the medical insurance card and cash.

3. There is a deductible for hospitalization reimbursement (the deductible standard is generally 65438+ 00% of the average annual salary of employees in the city last year), which means that the money from the deductible needs to be paid by itself, and the part that exceeds the deductible can be reimbursed according to local medical insurance regulations. The proportion of reimbursement varies from place to place, and different projects in different hospitals are also different.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-third employees should participate in the basic medical insurance for employees, and the employer and employees should jointly pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 24 The state establishes and improves the new rural cooperative medical system. Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.

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.