The difference between urban hukou and rural hukou in medical insurance reimbursement

The main difference between urban hukou and rural hukou medical insurance reimbursement lies in the different scope and proportion of reimbursement.

Medical insurance for urban residents refers to the insurance system in which urban residents get basic medical security and medical expenses reimbursement by paying medical insurance premiums under the framework of the basic medical insurance system for urban residents. Under normal circumstances, urban residents' medical insurance can reimburse a wider range of medical expenses and the reimbursement ratio will be higher.

Medical insurance for rural residents refers to the basic medical security and medical expense reimbursement insurance system obtained by rural residents by paying medical insurance premiums under the framework of the new rural cooperative medical system. The scope and proportion of medical insurance reimbursement for rural residents may be relatively low, but medical expenses can also be reimbursed within a certain range. It should be noted that there may be differences in medical insurance policies and reimbursement standards for rural residents in different regions, and local health departments or medical insurance institutions need to be consulted for specific conditions.

There are some differences between urban residents' medical insurance and rural residents' medical insurance in terms of coverage and reimbursement ratio, but both of them can provide basic medical security and medical expense reimbursement services. According to your actual situation and medical needs, you can choose to participate in urban residents' medical insurance or rural residents' medical insurance, or you can choose other forms of commercial insurance for supplementary protection.

The conditions for medical insurance reimbursement include the following aspects:

1. Payment status: medical insurance participants need to pay medical insurance expenses in full and on time, otherwise the right to enjoy medical insurance reimbursement will be affected;

2. Reimbursement scope: the scope of medical insurance reimbursement includes medical expenses that meet the requirements of the medical insurance catalogue, such as the expenses of drugs, examination, treatment and surgery in the basic medical insurance catalogue. If the medical expenses are not in the medical insurance catalogue, it is generally impossible to enjoy medical insurance reimbursement;

3. Mode of medical treatment: medical insurance participants need to see a doctor in a prescribed medical institution, such as a cooperative hospital and referral according to regulations. If you go to a non-cooperative hospital, the scope of medical insurance reimbursement is limited;

4. Reimbursement proportion: The proportion of medical insurance reimbursement is different, and it is generally reimbursed according to the proportion stipulated in the medical insurance catalogue. Different medical items have different reimbursement rates, for example, the reimbursement rate of drugs may be higher than that of medical expenses;

5. Reimbursement limit: the medical insurance reimbursement limit refers to the upper limit of the medical insurance reimbursement amount that medical insurance participants can enjoy within the specified time. If the limit is exceeded, the excess shall be borne by you at your own expense.

To sum up, the medical insurance policies in different regions will be different, and the specific medical insurance reimbursement conditions shall be subject to local policies and regulations. If you need to know the specific medical insurance reimbursement conditions and procedures, it is recommended that you consult the local social insurance bureau or relevant departments.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

The medical and military expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance carport insurance agency, medical institution and pharmaceutical business unit. 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.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.