Proportion of reimbursement for one old and one small medical insurance in Beijing

Legal analysis: the reimbursement ratio of one old and one small insurance in Beijing

First, outpatient reimbursement

1, deductible line

The deductible line of first-class and below medical institutions is 100 yuan, and the deductible line of second-class and above medical institutions is 550 yuan, with an annual reimbursement limit of 3,000 yuan.

2. Proportion of reimbursement

The reimbursement rate for first-class and below medical institutions is 55%, and that for second-class and third-class medical institutions is 50%. After the implementation of the new system, the highest reimbursement rate of outpatient service reached 55%, an increase of 5 percentage points.

Second, hospitalization reimbursement

1, deductible line

First-class and below medical institutions, small deductible line 150 yuan, old deductible line 300 yuan; Secondary medical institutions, the small deductible line is 400 yuan, and the old deductible line is 800 yuan; Medical institutions of Grade III and above, with small deductible line in 650 yuan and old deductible line 1.300 yuan, will increase the maximum annual hospitalization limit to 200,000 yuan.

2. Proportion of reimbursement

The reimbursement rate of first-class and below medical institutions is 80%, that of second-class medical institutions is 78%, that of third-class and above medical institutions is 75%, and the highest reimbursement rate of hospitalization is 80%, which is 5~ 10 percentage points higher than the original.

Legal basis: Social Insurance Law Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., to protect citizens' right to get material help from the state and society according to law in case of old age, illness, industrial injury, unemployment and maternity.